The historical development of applied kinesiology

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The

Historical Development of

Applied Kinesiology and its

Diagnostic and Therapeutic Usage David Leaf, D.C. , DIBAK Appendix Compendiums by Scott Cuthbert, D.C.

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Contents Introduction 3 The Beginning 5 Muscle Testing 17 Deltoid 19 Five Factors of the Intervertebral Foramina 31 Muscle Proprioceptors 33 Reactive Muscles 34 Spinal Extensor Muscle Weakness Pattern 36 Aerobic / Anerobic Muscle Testing 39 Challenge 51 Neurolymphatic Reflexes 54 Neurovascular Reflexes 55 Meridian - Muscle Relationships 60 Pulse Points 61 Alarm Points 62 Associated Points 63 Category II Pelvic Subluxations 65 Rectus Femoris 68 Sartorius 68 Gracilis 68 Gluteus Maximus 69 Hamstrings 69 Abdominal Oblique 70 Gluteus Medius 70 Muscle Testing and Upper Extremity Peripheral Nerve Entrapments 71 Costoclavicular Syndrome 71 Pectoralis Minor Syndrome 72 Suprascapular Nerve Syndrome 72 Pronator Teres Syndrome 73 Supinator Syndrome 73 Ulnar Sulcus Syndrome 73 Carpal Tunnel Syndrome 74 Cranial Motion 77 Respiratory Challenge 82 A Brief Discussion of the Neurology of Cranial Manipulation 83 Cranial Nerve Examination 85 Oral Nutrient Testing 89 A Pilot Study Showing Efficacy For Applied Kinesiology Muscle Testing Procedures as a Screening Tool For Immune System Mediated Food Allergy Patterns 91 Melzack & Wall Gate Control 97 Mental Recall 99 Injury Recall Technique 100 Alternative Pain Control Technique 102 Acupunture Meridian Head Points Pain Relief Techniques 104

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Proposed Neurological Mechanisms for A.K. Pain Relief 106 Inflammation & Prostaglandins 108 Appendix A Partial List of Additional Procedures taught and developed in Applied Kinesiology Muscle Related Therapies 111 Antagonist Reactive Muscle Pattern 111 Ligament Interlink 111 Gait Testing 111 Synchronization 111 Right - Left Brain Activity 112 Gait Inhibition 112 Biological Closed Electrical Circuit 112 Repeated Muscle Activation (RMA) 113 Spinal Related Therapies 113 Vertebral Fixations 113 Hologramic Subluxation 113 Category I & II 113 Category III 114 Sacral Wobble 114 Iliolumbar Ligament 114 Meningeal Release - Coccyx 114 Spondylogenic Reflex 114 Cervical Compaction 114 Hidden Cervical Disc 115 P. L. U. S. 115 Piriformis Gait Inhibition 115 Pitch Roll Yaw-Tilt 116 Stride Length 116 Jugular Decompression 116 Cranial Dural Torque 116 Meridian Related Therapies 117 Then and Now 117 Muscle Meridians 117 Beginning and End Technique 117 Visceral Related Therapies 117 Visceral Manipulation 117 Ileocecal Valve Disorders 118 Malabsorption 118 Respiratory Procedures 118 Lymphatic Disorders 118 Robert Fulford Concepts 118 Anatomy Trains 119 Appendix B Applied Kinesiology Status Statement 121 Appendix C Links to Applied Kinesiology’s Published Research Papers as of June, 2012 124

Introduction Applied kinesiology began as a simple observation by the inquisitive mind of a very talented doctor. Many think of applied kinesiology as solely the work of George Goodheart. Dr.. Goodheart made three independent observations and these are

1. A muscle can change strength rapidly if properly treated 2. There is an organ muscle relationship 3. Therapy localization

Every other technique or procedure in applied kinesiology came from other sources and muscle testing was applied to improve the usefulness of the procedure. From the field of medicine come the works of Travell, Sutherland, Jones, Wirt, Perk, Nordstrom, Mann, and the list goes on. For over 40 years, Dr. Goodheart and others in the international College of Applied Kinesiology have looked to improve the works of others. This book has been written with a goal of exposing you to the concepts of applied kinesiology. It is not intended to teach you how to do applied kinesiology. The ICAK has developed an introductory course and advanced courses to accomplish that. The purpose here is to demystify applied kinesiology. The book borrows on the works of Walther, Schmitt, Powers, Belli, Grossman and Goodheart. The other parts are from a book that I have written “The Flowchart Manual of Applied Kinesiology”. Dr. Scott Cuthbert has done and continues to do a yeoman’s work at keeping all of the research papers on applied kinesiology organized for you to find. After exposing yourself to the benefits of applied kinesiology, we hope that you will pursue your knowledge and discover how the principles of applied kinesiology can aid every doctor and their patients. David W. Leaf, D.C.

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The purpose of this book is to give you an overview of how applied kinesiology came to be. Starting with my original observation that, in most cases, the strength of a weak muscle can be changed almost instantly, to the latest procedures in applied kinesiology, these procedures are based on principles of neurology and physiology. Most of the procedures and techniques in applied kinesiology were observations or developments of other health care professionals. The problem was that most of these techniques did not have a diagnostic test for their use. They were empirically used. What we have done is to develop a diagnostic test using the patient and muscle testing. The beauty of applied kinesiology is that it aids any practitioner to become better at analyzing what treatment procedure is the best for the patient. Too often, the patient is fit to the treatment. In applied kinesiology, we have refined over 40 different treatment options that can be tested for their appropriate usage using muscle testing. The procedures enhanced by this run the gamut from physical therapy, osteopathy, chiropractic, medicine and oriental medicine. I hope that this course lights a fire in you, as it has in so many others. Applied kinesiology is not the work of one but the findings and hard work of many. The use of applied kinesiology, as taught by the ICAK, has spread in dentistry and medicine. It is now a subspecialty of medicine in Austria and is spreading in these professions throughout Europe, Russia, Japan and Korea. In closing, I would like to leave you with one thought. When confronted with a problem patient, ask “Why?” This was a lesson my father taught me in my first years in practice and it is a question I have asked myself for years. This is the reason that this body of knowledge happened, simply by asking “Why” and then searching for an answer. George Goodheart, D.C.

Acknowledgment I would like to thank the following authors for giving permission to use their works in compiling this book. These include George Goodheart, David Walther, Kathleen Powers, Walter Schmitt, Richard Belli, Scott Cuthbert and Jason Grossman. This book was designed to expose the student to the development of applied kinesiology and to be used along with demonstrations of its use by the instructor. It is beyond the scope of this book to actually teach the procedures needed to apply the principles of applied kinesiology. The International College of Applied Kinesiology has developed courses for the student to become trained in accurate muscle testing and the procedures introduced here. It has been my privilege and honor to have known Dr. Goodheart for over 35 years and be able to bring this material to you. David Leaf, D.C.

All rights reserved. No part of this book can be used without the written consent from ICAK-USA. Published by ICAK-USA Copyright © 2012 by ICAK-USA 6405 Metcalf Ave., Suite 503 Shawnee Mission, KS 66202

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The Beginning by George Goodheart D.C. Reprinted from You’ll Be Better I graduated from the National College of Chiropractic in Chicago, Illinois in 1939, and previously attended pre-chiropractic at the University of Detroit. I began practice in association with my father late in 1939. However, the advent of World War II didn’t give me much time to practice. I went through the Air Corps Cadet Program in 1941, during the early war years, but through a happy series of fortunate events became involved in innovative air operations research, so my active practice really began in 1946 following my release as a Major from the United States Air Force. Having left the Air Force in 1946, I resumed active practice in association with my father until his death in the early ‘60s.

was a stocky young man who was quite well built, and had recently been discharged from the paratroopers, but despite apparent good health he was suffering from a rapid hair loss. Examination revealed a hyperthyroid problem, and at that time we were measuring the thyroid function as we still do, by measuring the speed of the Achilles tendon reflex. The Achilles tendon is put on a stretch and tapped with a testing hammer; then the speed of the Achilles as it moves, just as your knee would jerk under the knee jerk test, is measured by its path through a photo-electric beam. This impulse is transferred electrically to an EKG, which then gives a printout of the degree of functional capacity of the Achilles tendon to respond to the tap.

The normal time is 330 milliseconds, and his was abnormally fast, approximately 220 ms. 220 milliseconds was quite fast, and Because of my father’s background in general nutritionally I had learned that natural practice, ours was a general practice, and we amounts of Vitamin A and a source of saw many patients with many problems. As Thymus, a small gland around the windpipe is usually the case, the further along I got which is associated with auto immunity, were in practice the more intelligent my father practically specific for hyperthyroid problems, seemed to become-the obvious fact being that along with regular chiropractic care. Upon I became more aware of my inadequacies and administering this nutritional support and the his excellent qualities; and I grew in stature proper treatment mechanically, he showed a and development because of my association tremendous response in about two weeks. His with his very, very practical and superb hairline stopped receding, for which he was very grateful and pleased, and he asked me diagnostic and clinical work. advice about another problem. My time in the Air Force had given me a taste for innovative opportunities, and also had taught me a practical method of dealing with problems, and this was to stand me in good stead later on.

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He mentioned that he couldn’t get a job in any of the factories in our town because he was unable to pass the physical-and the reason he was unable to pass the physical was his inability to press in a forward direction with one of his arms. One of ‘his shoulder Not long after my father’s passing, a young man blades stuck out in a rather unusual fashion, presented himself at the office complaining protruding from the chest wall. He asked of a relatively common problem, although me if I could do anything about it. I said, at a very early age. He was losing his hair. “Well, probably it’s some type of anomaly, a He had a rapidly receding widow’s peak, and variation in a probably normal function.” We at the age of 24 seemed quite concerned. He did some x-rays to prove this potential which

revealed no abnormality, and I could offer him no further advice as to why this particular condition was present.

of inactivity that occurs, for example, if you keep your arm in a cast and the muscles wither from lack of activity.

Either fortunately or unfortunately, depending upon your point of view, I was able to procure a job for him with one of the companies in the building where we had our offices, a nutritional company with whom we. did a lot of business. He would come into our office, and quite often in a crowded waiting room would ask me in a loud voice, “When are you going to fix my shoulder?”. This embarrassed me somewhat, and I motioned. him to come into the inner office quickly, away from the sight and scene of my embarrassment, and I would tell him that there wasn’t much I could do about it.

Upon palpating the muscle I felt an unusual nodulation at the attachment of the muscle to the anterior and lateral aspects of the rib cage, which I didn’t feel on the other side. The small nodulations were quite apparent to the palpating finger, and in an effort to identify their nature I pressed on them. They were not painful other than minimally so, and they seemed to disappear as I pressed on them with my palpating pressing finger.

Encouraged by the apparent disappearance of the first one or two, I continued to press on all of the small areas which we later learned to be avulsive in character, a tearing away of the Having been embarrassed for the last time by muscle from the periosteum. The attachment his frequent inquiry, I resurrected a book that of the muscle to the covering of the bone, had been given me by a colleague of mine, Dr. the periosteum, was producing a nodulation Raymond Koshay, a very fine chiropractor which is characteristic in these cases of micro in Port Huron, Michigan whom I had been avulsion. They are small tearings away of able to help with a knee problem; and for muscles from their attachment. Christmas he had given me a copy of the book. I remembered that there was a muscle that pulled the shoulder blade forward so that it Having palpated and pressed on all the would lie flat on the chest wall, but something small nodulations which coincided with the like the old adage-what you don’t use you attachments of the muscle to the rib cage, I lose - I knew the muscle existed but I wasn’t then surveyed the muscle. It felt the same, sure of its actual origin and insertion. When I but this time I noticed his scapula (shoulder applied myself to the .book he had given me, blade) was lying in a normal position on the “MUSCLE. TESTING” by Kendall & Kendall, posterior chest wall. I soon found the muscle that pulled the shoulder blade forward on the chest wall was the anterior serratus. There was a method for Surprised but pleased, I repeated the test, testing it which involved placing the patient’s having him place his hands in front of him hand on the wall, and then pressing on the against a plywood panel that separated spine in a forward direction, and the shoulder one section of the office from another, and I blade immediately stuck out. pressed hard on his spine. The shoulder blade did not pop out, and he looked at me with an inquiring glance and said, “Why did you not In an effort to identify the cause of the problem do that before?” I looked back at him, serious I palpated the muscle. He said he had the of face and direct of eye, and said, “Well, you condition as long as he could remember-15 have to build up to a thing like this. You didn’t or 20 years-yet when I palpated the muscle get sick over night.” It was an automatic left and right, on the side of involvement, I response, but all I could think of at the time. found no atrophy of disuse-the usual pattern 6

technic, he had been unsuccessful in relieving the patient’s pain or changing the disability which was diagnosed by the pattern of muscle testing. The muscle would test consistently weak on the side of involvement: tested by In an effort to identify this unusual reaction, requesting the patient to abduct, moving the yet not reveal my surprise, I requested him leg sideways, and then requesting the patient to return to the office the next day so I could to resist the pressure to take it medially. This check his hair loss. He advised, surprised, was accomplished while the patient was in that he hadn’t lost any hair in six months. I the supine, back lying position. mentioned that he could never be too sure, so he showed up the next day. I looked at his hair and said it looked fine. Then I said Because of the unusual history, I felt that this “By the way, let’s test that muscle.” I tested was an involvement of the lymphatic system, the muscle, and it remained strong-and it which is the sewer or drainage system of the has remained strong ever since! I have seen body. It is drained by a variety of modes, but this patient from time to time since that first fundamentally it is drained by the squeezing incident, which occurred in 1964. action of the muscles on the lymph system. Because walking relieved it, indicating this possibility, I palpated the lymph glands on Emboldened by this unusual success, I began the lateral aspect of the thigh and felt nothing to test muscles by the method of Kendall & unusual in comparison to the uninvolved left Kendall, a method which is used by military, side. civil and government agencies to rate disability and is a standard method of diagnosis. I found many patients showed muscle weakness. I palpated also for the potential of any Many patients also denied a history of sacroiliac disturbance, because occasionally trauma, but many patients responded to the we get lymph nodulation in the region of hard heavy pressure at the origin insertion, the sacroiliac joint if there is a sacroiliac although many did not. disturbance. I found none of these, and the patient was in a great deal of distress while lying on his back. After palpating for Fundamentally, my rate of success with diagnostic information, which I did not find, patients was rising and I had communicated the patient looked up at me and said, “That’s this method of testing along with the the first relief I’ve ever gotten.” I looked at rather primitive method of treatment to him and said, very bravely, “That’s what you my colleagues. One of those colleagues, Dr. came here for,” indicating that it was not the Pat Finucan, sent me a patient who had an surprise to me that it was. unusual type of sciatic neuritis, a painful problem involving the lower limb that would cause severe pain if he were to stand, sit or Astonished by this rather quick success and lie down, but would disappear when he would yet not understanding the basis, I continued to walk. Dr. Finucan had found a weakness of initiate the palpation which I had accidentally the fascia lata, the muscle covering the lateral used to relieve his pain. He remarked that portion of the thigh associated with movement the pain which he had experienced for many, outward of the leg. many months was now completely absent, and subsequent investigation and diagnosis revealed a complete disappearance of the Despite efforts to correct it mechanically at the long-standing and chronic irritation of the spine and locally, using the origin insertion sciatic nerve. He was pleased, I was delighted. It was an unusual thing to see this quick a response.

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CHAPMAN’S REFLEXES,” the second edition, which had been reprinted by the Academy of My secretary, who had been with me for Applied Osteopathy, copyrighted May 6, 1946. many years and who was a very fine German It had originally been copyrighted in 1937 by woman, had quite a bit of sinus trouble and Charles Owens, . D.O., and was a book on would consistently show a head tilt when she the diagnostic and therapeutic application of would have a sinus disturbance; and despite neurological reflexes that had been the work the fact that I could find a weakened muscle of Frank Chapman. Both Dr. Chapman and which I associated with the head tilt, the Dr. Owens had postulated the existence of original technic that had been used on the a reflex called the neurolymphatic reflex-a young man with the hair loss did not produce cutaneous visceral reflex that had been under any muscle strengthening, nor did it affect investigation at the Kirksville College of the sinus involvement. Osteopathy and Surgery. Thinking that one had to simple palpate and treat the muscle, such as had been done to the sciatic patient earlier that afternoon, I tested her neck flexors by having her raise her head and turn it slightly to one side, and they showed immediate weakening on testing. I attempted to repeat the procedure that had helped the sciatic patient, running my hand along the lateral aspect of the muscle, the sternocleidomastoid muscle that runs from the back of the head bone to the collarbone. I felt nothing different on palpating and testing the muscle, using the technic that I had palpated and tested earlier on the gentleman with the sciatic neuritis. I tried triumphantly to test her neck muscles again, and to my chagrin her neck muscles were possibly even weaker than before, and I almost injured her head by the sudden collapse of her neck to the testing direction of my hand. I said rather despairingly, “It sure seemed to work on that fellow this morning. I can’t understand why it doesn’t work on you now.”

“The surface changes that are present in a Chapman’s reflex are palpable.” Dr. Owens spoke of the changes found in the deep fascia as well as the superficial tissues located at specific points (loci) and consistently associated with the same viscera. These little tissue changes, which began in the form of contractions, are located anteriorly in the intercostal spaces between the ribs near the sternum. They may vary in size from a half of a BB shot to that of a small shot gun pellet, and are generally multiple. This type of tissue change is apparent in some of the reflexes found in the pelvis; but the ones found in the lower extremity, associated with the colon, broad ligament and prostate, vary in character.

By trial and error, testing muscles and then comparing areas that Chapman had originally talked about, we found which circuits affected which muscles. Then, by trial and error and also by examination of a particular patient who had Hodgkin’s Disease, and who exhibited nodulations and lymphatic gland characteristics inherent as characteristic of Hodgkin’s Disease, we found that many of the nodulations corresponded precisely Then I thought, perhaps what I pressed on to the areas that Chapman had originally was something unassociated with the muscle postulated; and by trial and error, and also itself, but associated with, possibly, some by the discovery of nodulations in areas that lymphatic circuit breakers which had been Chapman had not discussed, we were able postulated by an osteopath named Chapman. to find the neurolymphatic reflexes for most This had later on been discussed in a text, muscles. “AN ENDOCRINE INTERPRETATION OF 8

By now I was becoming convinced that there was a relationship between muscles and particular viscera or organs. A moderately weak muscle on testing appeared to be associated with a weak viscera or organ, but every time I could see evidence of a weak pancreas, or a weak stomach, or a weak liver or a weak kidney dysfunction-of those organs which would be measured by x-ray or by biochemistry or by some other accepted biological test-I would find a corresponding weakened muscle. This relationship, although rather tenuous at first, became more and more evident as time went on.

breaker if closing the panel did not already do so. In other words, she would have to do two things: rearrange the rug structure, so to speak, and then also set a circuit breaker. We postulated that the lymphatic centers were circuit breakers in this sort of anal ago us context. This proved to be a valuable system of analysis and the response rate continued to rise in patients, and we started to see more and more patients upon whom we did more and more muscle testing.

An Italian woman came to see me and complained of a headache for 30 of her 49 This began to explain, at least somehow, the years, and on testing the muscles I observed visceral response that occurred from muscular some muscles to be weakened on both the skeletal corrections and made a little more right and left sides of her body. I noticed sense out of the observations that patients used that in an effort to maintain a response to to make following treatment for a muscular testing of certain muscles, if she took a deep skeletal problem, and with the spontaneous breath some muscles, for example on her resolution of the visceral or organ problem. I right side, strengthened; but the same deep found a strong relationship to exist between breath seemed to weaken the muscles on her the spinal level of neurolymphatic activity left side. But instead of taking a deep breath and structural aberrations of the spine, but and producing strengthening on her left side, this was not always the case. letting the air OUT seemed to strengthen the muscles on her left side. It was just as if there might have been an original subluxation or lesion of the spine, a functional disturbance of the spine, that somehow was either self corrected spontaneously or corrected by manipulation; but the long term effects of that disturbance continued to remain. For example: if you have a home washer-dryer and perhaps place a heavy object such as a rug in it, as it starts to spin it dry, the rug’s eccentric position in the spinning washer causes a vibration, then the vibration sensor in the washer turns the washer off to prevent damage from the eccentric rotation. This usually sets an alarm going as well as turning the washer off, and the housewife then attends to the problem by opening the panel on the washer, and seeing the rug in an eccentric position rearranges the rug. Then she closes the panel on the washer and many times must then reset a circuit 9

She also exhibited a rather unusual configuration in terms of analysis of the level of her head. Looking at the position of her ears in relationship to her head, her ear was lower on the right than it was on the left, as was her occiput, the bones of her skull. Looking at her from the rear confirmed this position, lower on the right, but looking at her on a .face view, head on, an anterior look showed her eyebrow and eye to be higher on the right and lower on the left, just the opposite of what I had observed looking at her from the posterior view. Thinking perhaps that her ears were in an altered position, I compared her ear position by measuring down from the vertex and I found that the ears were equally spaced an her head measuring from the top down, yet there

was an obvious discrepancy between the level “Well, that’s what you come here for,” to again of her ears and the level of her eyes, instead of disguise my surprise at her rapid response. making a parallel pattern they made a wedge pattern, which was very confusing. We then began to test muscles against phases of respiration, and we found many muscles I had been aware of the work of William responded to inspiration, some responded to Garner Sutherland, an osteopath who had expiration, and interestingly enough some postulated the concept that the bones of the responded to half a breath taken out, some skull move as you breathe like the gills of a responded only to a breath taken only at fish. He developed the concept that there the nostrils and some responded to a breath was a vestigial gill mechanism in the skull, taken only at the mouth. Some responded to and by long experimentation with himself, breathing through one nostril as opposed to using many ingenious devices, had attempted the other, and some responded in an opposite to limit the motion. He observed his own fashion. response, and published an original text based on his observations entitled, “THE CRANIAL BOWL,” by William Garner Sutherland. We soon found fourteen basic cranial faults His work had later been documented and which will be discussed later, but the primary revised by Harold Magoun, D.O., entitled investigation method was to find a weakened “OSTEOPATHY IN THE CRANIAL FIELD.” muscle. Both the first and second editions of Dr. Magoun’s books are available. We had the patient take a deep breath in or out. If the muscle was found to be weak and The concept that the bones of the skull had responded to inspiration, the mastoid process motion seemed contrary to my anatomical on the side of the skull that the muscle and osteological training, yet in an effort to weakened was located and pressed forward at understand the problems produced by the the temporal bone mastoid process with the patient I was examining, I attempted to move thenar eminence of the hand, with about 4 or the mastoid process on one side of her head 5 pounds of pressure coincident with 4 or 5 in a forward direction while she took deep deep inspirations. inspirations, and at the same time moved the mastoid process in a backward direction while she took a deep expiration-in other words, If the muscles found weak responded to using a counter-torque motion with the fleshy expiration, the thenar eminence of the hand part of my thumbs, the thenar portion of the was placed anterior to the mastoid process of palm of the hand-and the forward motion the temporal bone and the mastoid process and the backward motion were accomplished of the temporal bone was pressed backward simultaneously on this 49-year-old Italian towards the occiput coincident with 4 or 5 deep woman. expirations using 4 or 5 pounds of pressure. After 4 or 5 deep inspirations and expirations, despite the fact that she had attempted these before, but not with the concomitant skull pressure, she looked at me and her eyes widened, and she said, “That’s the first relief I’ve ever gotten.” I looked at her, again serious of face, and with true sincerity said, 10

This resulted in many, many cases improving from many, many conditions, and they postulated a concept of a cerebral spinal fluid flow rate something like a dual irrigation ditch-with someone turning the rheostat down on the pump, and the tomato vines withering somewhat, and then when someone turned

the rheostat up on one side or the other, the tomato vines thriving due to an increased flow By now we had the original methods of of the irrigation fluid. muscle testing with the concept of micro avulsion origin insertion technic; we now had the possibility of lymphatic blockageInvestigation revealed that not only did the in other words, the muscle couldn’t flush its bones of the skull move in a predetermined own lymphatic toilet; we now had the concept fashion, but so also did the vertebral segments of cranial technic, respiratory systems; and in which vertebrae went through a rocking we also had, prior to the development of type of motion-the tip of the spinous process cranial technic, the system which we call of a vertebra involved moving in an inferior neurovascular response. direction towards the feet with inspiration and a superior direction with expiration. The I was lecturing in Rochester, New York spinous process moves inferior, footward, with discussing the original method of hard, heavy inspiration and headward with expiration. pressure at the origin insertion of the muscle in case of weakness caused by micro avulsion, and also demonstrating the lymphatic technic We soon found there was also a sacral motion, for finding the source of blockage in the the tip of the sacrum at the coccyx moving lymphatic range of muscles. I was asked to forward with inspiration, toward the front of treat a young boy with asthma who was having the body, and moving backward, toward the an acute attack and who did not respond to back of the body, with expiration. We found the usual medications. He was having some a reverse movement to exist in the coccyx, a response to chiropractic technic by a young counter movement between the sacrum and chiropractor attending the lecture, but he was the coccyx. We also found a counter movement suffering an acute asthmatic episode at the between the total pelvis, the pelvis moving time of the lecture, during the lunch period. backward as the sacrum moved forward and the pelvis moving forward as the sacrum moved backward, coincident each time with By now we had found that the adrenal glands phases of respiration. were responsible to a great extent for failure to produce adequate adrenalin, agreeing with the medical approach-the crisis care type of This new cranial finding coincident with approach to asthma seemed time honored, at a method of diagnosis aided greatly in the least pharmaceutically. We would find a weak application of the cranial concept. The sartorius gracilis muscle which time had original Sutherland concept, as well as those shown to be related to potential failure of the that followed, used topographical, anatomical lymphatics of the adrenal gland to flush its changes for cranial corrections; but the own toilet, so to speak-its lymphatic toilet. But addition of respiration added a measure of investigation of the neurolymphatic reflexes diagnostic certainty and also safety to this and treatment for them did not change the relatively new science. weakness that we found on testing of the sartorius muscles. Time has shown that a respiratory relationship exists in the spinal fluid flow rates, and a critical factor in the production of routine The young boy was lying on this back, one foot cranial correction was to correlate muscle pointing straight up and the other foot lying weakness to strengthen with respiration. loosely to one side. In an effort to correct the More of this will be discussed later on in problem I had already used the neurolymphatic chapters on cranial technic. reflex and had attempted an origin insertion technic without any success. I knew that 11

occasionally the lymph system was sluggish because of failure of the lymph system itself to drain, and I was using what was called a lymphatic pump. The operator’s fist first was placed on the sternum of the individual and moderate pressure was exerted spineward while the patient attempted to take a deep breath. At the middle of the attempt to take a deep breath the fist was suddenly removed, causing the succussion of the chest, changing the pressures within the chest, and literally succussing or shaking the thoracic duct, allowing better lymphatic drainage potential. This too was unsuccessful, but at that time I was aware of a primitive cranial technic of simply spreading the cranial sutures as advocated by Dr. James Alberts, Sr., a very fine chiropractor in the southwest. In attempting to spread the cranial sutures in a very simplified fashion, I did not see any change, and in an effort to evaluate the problem I sat down and re-attempted to spread the sagittal sutures. From experience I had learned that this was of some value occasionally in lymphatic blocks. My index fingers were resting on the posterior fontanel area with the rest of my fingers spreading the sagittal suture which runs vertically along the top of the skull, separating the two halves of the skull and joining the parietal bones of the skull together. I felt that insistent pulsation, very faint at first, at the posterior fontanel; and despite the fact that his carotid arteries were beating at the rate of about 120 and his respirations were at least 40, I noticed that the pulsations that I experienced with my fingertips were at the rate of 72 beats per minute. Thinking the beating was perhaps in my own fingers, I removed my fingers and placed them on a wall to identify if the 72 rate beating was in my own fingers. I noticed no change. I reapplied my fingers to the posterior fontanel and felt the continued pulsation, which became 12

more insistent and more persistent and more evident in strength, until finally the young man gradually stopped his labored breathing, took a deep breath, began to breathe easily, and simultaneously his foot rotated up into a parallel position with its opposite member. The doctor attending the youngster, who had asked me to see the patient, looked at me and said, “Good gracious, Doctor, that’s marvelous.” And I looked at the doctor, very serious of face, and said, “That’s what you come here for.” We now had developed another method, called the neurovascular technic, for the correction of muscle weakness. In the embryo there is no heart, and for the first three or four months the mother’s placental circulation is augmented by a network of vascular circuits which, as the tissues grow, exert slight traction on the blood vessel which then causes the blood vessel’s muscles themselves to pulsate in an augmented fashion, aiding the mother’s placental circulation. At about the fourth month the heart is formed, and many times the mother is delighted to hear the heart beat that her obstetrician allows her to listen to. At the advent of the heart beat, the heart takes over part of the burden of supplying circulation to the growing embryo, and the neurovascular circuit of supply and demand circuitry goes on a standby basissomething like a generator behind a hospital in case of power failure, which can be turned on for emergency use. These neurovascular receptors were first discovered by a chiropractor in California named Terence Bennett, who developed a foundation for teaching his material and who wrote extensively in the early ‘30s and ‘40s of their use. Upon his departure from

active practice, and upon his death, Dr. Floyd Slocum, one of the early pioneers in the American Chiropractic Association, took over his activity and the Neurological Research Foundation continues to be active under the auspices of Dr. Martin King from California.

We find that many muscles lack a “thermostatic” configuration which allows them to function when under stress, and attention to the neurovascular receptors by a light tugging touch allows much better circulation to the muscle.

When a light tugging touch was applied to the vascular circuits a pulsation was felt beneath the finger. The light tugging touch is maintained for 20 or 30 seconds minimum time, the muscle is tested before and after, and many times this coincides with the need for cranial fault correction. But in any event, the light tugging touch is maintained for a variable period of time, a minimum of 20 or 30 seconds, and the muscle tested before and after to ascertain the return of strength.

We continue to observe the muscleorgan relationship and we were becoming increasingly convinced of the reasonably frequent relationship between weak organweak muscle, although we were not convinced of the contrary relationship of the weak muscle-weak organ.

We now had four options for strengthening weak muscles. W~ had the hard heavy pressure described earlier, the activation of the lymphatic reflexes, the application of It is just as if the neurovascular receptor cranial technic, and the use of neurovascular acts as a thermostat. If the thermostat is receptors. set too low the muscle doesn’t get its proper circulation and the muscle’s lactic acid and other products of mechanical contraction of The subject of acupuncture has long been a the muscle are not flushed or washed out, and point of interest, but not much was-known of the muscle therefore is clogged with its own this concept until the early work of Bennett waste products and shows weakness. Cerf, who published in Random House publications the book, “ACUPUNCTURE, ANCIENT CHINESE ART OF HEALING,” Roger Bannister, who ran the first four minute by Felix Mann, an English physician. Some of mile, became a vegetarian - not through the early Jesuits who had been missionaries embracing of the vegetarian concept, but in China had spoken of the unusual responses because the vegetarianism put less of a load that were obtained in many instances from the on his liver and he was able to oxidize excess practice of acupuncture, the insertion of tiny lactic acid produced by the increased effort to needles of metal or bamboo into prescribed run the four minute mile. Lactic acid, as it is areas on the skin of the sick patient. produced by the muscle in function, causes the capillaries to dilate; and finally there is a status quo reached by the lactic acid level To quote Felix Mann in his acknowledgements producing the greatest amount of capillary at the beginning of his book, “ACUPUNCTURE, dilation. When the lactic acid reaches higher ANCIENT CHINESE ART OF HEALING” level, there is no further capillary dilation now published by James Heineman Company, until the liver goes into “overdrive” and Medical Books Ltd., London, “All European attempts to oxidize off the excess lactic acid; acupuncturists owe Soulie de Morant a and here, then, the muscle can resume a debt for his original translations of Chinese normal function. treatises. He developed much understanding of the subject and its practical application during the time he associated with Dr. Ferey 13

Rolles. Those who read Chinese are few, but many may be greatly benefited by the French and German books on acupuncture mentioned in the bibliography.”

which included many of the aspects of acupuncture, giving four points to tonify or stimulate the area and four points to sedate if the organ was overactive.

Acupuncture is an ancient Chinese system of medicine in the practice of which a fine needle pierces the skin to a depth of a few millimeters and is then withdrawn. The only thing of real importance in the study of acupuncture is to know at what point to pierce the skin in relationship to which disease.

In an effort to relate these points to kinesiological parameters, we attempted stimulating the points for tonification and found occasional responses in muscles. We attempted to sedate other points and found occasional responses in muscles. Insertion of a needle at the so-called “first point” invariably would produce a strengthening of a muscle if found weak on testing, and insertion of a needle The notion that a pin prick, often in a part at the first point of sedation would invariably of the body far removed from the seat of the cause weakness of the muscle if the muscle disease, can cure ills is alien to conventional was strong. We soon found that touching the thinking. It is unfortunately the case that first two points for tonification would result in many doctors, even when faced with several strengthening of a weak muscle. The converse former patients who have been cured by was also true. Touching the first two points for acupuncture where other efforts have proved sedation and simultaneously the second two fruitless, have refused to believe the evidence. points for sedation would weaken the muscle. Acupuncture is not the exclusive possession of the Chinese. The papyrus ebers of 1150 B.C., one of the most important of the ancient Egyptian medical treatises, refers to a book on the subject of muscles which would correspond to the 12 meridians of acupuncture.

We wrote the first book on acupuncture in 1966, showing its relationship kinesiologically, and this was the only research manual that did not go through a second reprinting, because the concept was too new at the time. However, since that time it has grown to be a standard portion of Applied Kinesiology and forms a The Bantu sometimes scratched certain parts basis of much of the information we have been of the body to cure disease. In the treatment able to identify about acupuncture. of sciatica some Arabs cauterize with a hot metal probe a part of the ear. Some Eskimos We now have five arrows, so to speak, in practice simple acupuncture with sharp our quiver. We could shoot the arrow along stones. An isolated cannibalistic tribe in the origin insertion, the neurolymphatic, Brazil shoots tiny arrows with a blow pipe at the neurovascular, the cranial, and now the certain parts of the body. acupuncture path. Each of these develop their own special set of rules and special set of circumstances. A patient, and a good friend, had returned from Hawaii and brought me one of the first How The Body Heals Itself copies published by Random House of Felix Mann’s book. By now we have become pretty Applied Kinesiology is based upon the fact that well convinced of the relationship between body language never lies. The opportunity of viscera and muscle. In the chapter of Felix understanding the body language is enhanced Mann’s book entitled “The Five Elements” on by the ability to use the muscles as indicators page 92, he spoke about an organ relationship for body language. The original method for 14

testing muscles and determining function, by the methods of muscle testing first advocated by Kendall and Kendall, is a prime diagnostic device. Once muscle weakness has been ascertained, a variety of therapeutic actions are available which are too numerous to enumerate here. The opportunity to use the body as an instrument of laboratory analysis is unparalleled in modern therapeutics because the response of the body is unerring. If one approaches the problem correctly, makes the proper and accurate diagnosis and treatment, the response is adequate and satisfactory both to the doctor and the patient. The name of the game, to coin a phrase, is to get people better. The body heals itself in a sure, sensible, practical, reasonable, observable, predictable manner. ‘The healer within can be approached from without.” Man possesses a potential for recovery through innate intelligence or the physiological homeostasis of the human structure. This recovery potential with which he is endowed needs the hand, the heart, and the mind of a trained individual to bring it to potential being, and allow the recovery to take place which is man’s natural heritage. This benefits man. It benefits him both individually and collectively, but it also benefits the doctor who has rendered the service and allows the force that created the structure of the body to operate unimpeded. This benefit to man can be compounded by knowledge with physiological facts and with predictable certainty.

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Muscle Testing History Muscle testing is the basic tool used in applied kinesiology. Kendall and Kendall wrote the first book on manual muscle testing in the late ‘40’s based on their work with polio victims. They used a five point system for grading muscle strength. In applied kinesiology, we use a muscle test that has been described by the Institute of Sports Medicine and Athletic Trauma, as a “ break test technique “ method. The basic concept of muscle testing is to challenge the ability of the muscle to adapt to an increase in force after the patient has reached maximal contraction of the muscle. Muscle testing is an art as well as a science and it takes time to become proficient in learning muscle testing. The rules are rather simple. 1. Approximate the origin and insertion of the muscle and place the body part in a position that minimizes other muscles that can contract to support or recruit during the contraction of the prime mover. 2. Supply adequate support to the person being tested so that they do not move or alter their position during the test. 3. Use a broad flat contact with the fleshy portions of your hands so that you do not cause pain or discomfort where you test or stabilize the patient. 4. The testing pressure is applied at a 90-degree angle to the arc of movement of the body part. Another way of saying this is that the pressure is applied at the tangent to the arc of the movement of the body part. 5. Try to keep your forearm in line with the direction of force. 6. Testing should be done using your weight not your hand or forearm strength. The amount of 17

force depends upon the relative strength and health of the person you are testing. 7. Instruct the patient to apply pressure against your hand. When you feel the patient apply the pressure, increase your resistance against their pressure. When there is no increase in pressure, apply an additional force in the testing direction. You are testing the patient’s ability to react and adapt to the additional force applied.

The top picture shows the starting position of testing of the psoas muscle. Stabilization is given to the opposite pelvis upper thigh. A broad contact is used. Recruitment usually begins as a change in the angle of the pelvis or rotation of the femur. The stabilizing hand can detect these changes in the pelvis. The testing hand will detect the attempt of the subject to rotate the femur so as to recruit with the quadriceps. The soft portion of the hand is applied over the lower leg taking care to avoid any hard contact over the malleolus. The angle of the test can be varied along the arc of the motion of the leg.

The graph to the right shows the normal response to muscle testing. Pressure is applied and resistance given until you reach a maximum level. Additional stress is then applied and the patient is able to adapt to that stress.

The lower graph shows failure to adapt to the additional stress. The part being tested appears to “break away”: thus the name Break Test.

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Deltoid

Action Abduction of the humerus. The anterior and posterior portions aid in flexion and extension respectively. The anterior and posterior sections can function synergistically with each other or in an antagonistic fashion.

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Applied Kinesiology: Manual Muscle Testing and the Motor Neuron Richard Belli, D.C. Manual muscle testing has been a tool for medical and chiropractic evaluation for decades. The use of manual muscle testing as a tool in the medical community is mainly limited to evaluation of pathology whereas, in the chiropractic community it has been used for evaluation of functional disorders. It took the genius of George Goodheart, D.C. to see the value of manual muscle testing as an evaluative tool for functional disorders of the human system. His discovery earmarked the beginning of Applied Kinesiology (AK). Years later, Walter Schmitt Jr., D.C. coined the term, “muscle testing as functional neurology”, that started the era of describing the functional neurological aspects of manual muscle testing, and realization of the breadth of possibilities that manual muscle testing affords.

of inhibition of the motor neuron.. A muscle is simply contractile tissue that is depolarized by an efferent signal from the motor neuron. A weak muscle simply means that the muscle being tested is not appropriately depolarized by the motor neuron. Therefore, a more appropriate term would be a “neurologically inhibited muscle”. Hence one who uses manual muscle testing as an analysis tool needs to realize that muscle testing is simply a test of the function of the motor neuron.

The anterior horn of the spinal cord is the location of the cell body of the motor neuron. The functional state of the anterior horn is maintained by convergence of multiple ascending and descending pathways. The descending pathways originate at suprasegmental levels both pyramidally and extra pyramidally. The ascending pathways are sensory pathways that are either of somatic or visceral origin. The descending pathways can be of conscious origin in which the subject voluntarily motivates the muscle, or it can be of reflexogenic origin that is involuntary. Ascending pathways may be sensory from a variety of origins Over the decades that muscle testing has ranging from mechanoreceptors in skin and been used as an analytical tool, there have joints to nociceptive fibers from soma and been a multitude of meanings attached to a viscera. In an occurrence of a weak muscle, weak muscle. These include dysfunction of the total effect of the converging pathways the electromagnetic system, the lymphatic may shift the anterior horn so far towards system, the cranial respiratory system, and hyperpolarization that the neuron cannot be many more. But whatever you name the brought to it’s firing threshold, thus when the zebra, a zebra is a zebra, and the bottom line examiner tests the muscle the subject cannot in AK is that a “weak response” to a muscle resist the force of the examiner. test means that the muscle’s motor neuron is not functioning normally, limiting the ability There are a variety of reflexes indigenous of the subject to contract the muscle. In other to the human system that are necessary words, if the motor neuron is shifted too far to maintain life and limb. If there is either towards hyperpolarization then the subject somatic or visceral tissue dysfunction there cannot depolarize the motor neuron enough to will be an associated reflex affecting motor provoke a muscle contraction and the muscle neurons and muscle function. A classic tests weak. This leaves us with the question, example is an inflamed appendix in which “What does a weak muscle mean”? the patient cannot extend the right hip. This flexion contraction is a withdrawal reflex that The term “weak muscle”, in respect to AK, is a consequence of tissue irritation and a is actually a misnomer. The muscle itself is nociceptive driven withdrawal reflex. For every not actually weak. Assuming there is no end hypertonic muscle due loss of appropriate organ pathology, the “weakness” is the result inhibition of its’ motor neuron, there will be 20

a reflexogenic inhibition or “weakness” of its’ opposing muscle. As a result, nearly every visceral or somatic dysfunction will result in a neurologically inhibited muscle. Lesser degrees of this example come in the form of the weak muscles that are examined with manual muscle testing. The nervous system monitors and drives virtually all the systems in the human body. When there is dysfunction of any part of the human system the central nervous system knows about it, and attempts to respond accordingly. The soma and viscera communicate with the central nervous system both chemically and neurologically. Therefore it is reasonable to say that both chemical and neurological dysfunction can be analyzed with manual muscle testing. Regardless of the name of the technique used, whether it is acupuncture meridian stimulation, neurolymphatic technique, spinal adjusting or other osseous manipulation, if it strengthens a muscle it is bringing the anterior horn and associated motor neuron to a more normal state of function. Hardly a single human function takes place without involvement of muscles. With that in mind, and proficient knowledge of the human nervous system, the use of manual muscle testing in the form of Applied Kinesiology can provide an almost limitless tool for functional analysis of the nervous system and all that effects it.

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The Ventral Horn Cell What Happens When Muscle Strength Changes Kathleen M. Power, D.C., DIBAK, DABCI, DACNB THE VENTRAL HORN CELL When we test a muscle we are testing a number of parameters. We are testing the patient’s ability to listen and interpret what our request is. We are testing the capacity of the patient’s nervous system to translate our request into a motor event – the resistance of the muscle to our test pressure. The integrity of the motor response depends upon the ability of the motor neuron to reach a state of excitation sufficient to create an action potential. When we change the ability of the muscle to respond to our test pressure we have changed the ability of the neuron to reach its excitation threshold. Everything we do to, or for, a patient which has an impact on the strength of the muscle is related to this fact. In this article we will look at some of the factors involved in the ability of the neurons to reach an action potential and fire to its target organ, the muscle fiber.

these are both excitatory and inhibitory. Some presynaptic pathways to the ventral horn cells are segmental and some are suprasegmental. The ability of the ventral horn cell to summate and reach an action potential depends upon the addition of all excitatory and inhibitory influences from all of these pathways at a specific moment in time. SEGMENTAL INFLUENCES

Many of the local or segmental inputs into the ventral horn cell are associated with what we call the stretch reflex. In textbooks it is described as a simple phenomenon -- an afferent arc from the muscle spindle and an efferent arc from the ventral horn cell to the muscle -- but it is in reality very complex. It is complex because there are many collaterals to many other areas of the nervous system. Some of the collaterals from the spindle receptors go to other ventral horn cells to bring them closer to threshold or to allow them to fire. Other collaterals fire to segmental autonomic supply. Still others ascend to suprasegmental systems The efferent nerve is composed of large alpha which eventually modulate ventral horn cell motor neurons and small gamma motor output through descending pathways. neurons. The cell bodies of both of these are arranged in longitudinal columns at the anterior portion of the gray matter of the Segmentally, when the spindle receptor fires, spinal cord, the anterior or ventral horn. The it fires to the muscle in which it is located and alpha motor neuron supplies the primary to its synergists. It fires to muscles associated contractile tissue of the muscle. The gamma with it in a gait type of configuration. For motor neuron supplies the contractile portion example, if the PMC on the right is stretched, of the polar ends of the spindle receptors which the ventral horn cells to that muscle and its are embedded within the muscle tissue. Dr. synergists and to the contralateral anterior Goodheart has spoken of spindle receptors for lower extremity muscles will be excited; so many years. When the gamma motor neuron will the ventral horn cells to the contralateral fires, the ends of the spindle contract, thus upper extremity posterior muscles and the “preloading” it. In a more contracted state, ipsilateral posterior muscles. In addition, the spindle is more likely to fire with less interneurons which have an inhibitory action stretch upon the muscle. will be fired to inhibit the antagonists of the PMC on the right, to the left PMC, to the The motor neurons have thousands of right anterior hip and leg muscles, etc. We synapses on their dendrites and cell bodies; may observe this when we find a muscle 22

which tests weak; we may increase its ability to resist test pressure by asking the patient to contract a muscle whose reflex connections cause increased strength in the muscle. For example, a patient may present with a weak posterior deltoid on the right, but contracting the PMC on the left will increase resistance to test pressure of the posterior deltoid. SUPRASEGMENTAL INFLUENCES The primary presynaptic influences are descending suprasegmental inputs from many areas of the higher nervous system. These descending pathways change the ability of the ventral horn cells to summate; therefore, they modulate the ability of the stretch reflex and other reflexes to occur. We all learned in our neurology courses in chiropractic college that motor function is initiated in the contralateral cortex; this is essentially true although it has been shown that the cerebellum on the side of movement actually fires first. There are also ipsilateral cortical influences to motor function which are very important to ventral horn cell summation. Areas of the cortex called neocortex (only humans have this area) fire down to brainstem areas which then fire down into the cord. Their functional effects are to increase summation in ventral horn cells ipsilaterally, especially in upper extremity posterior muscles and lower extremity anterior muscles. The neocortex responds to environmental input from the contralateral side (with the exception of smell). It also responds to cognitive processes initiated in the contralateral cerebellum. When the neocortex increases its firing, both the alpha and gamma motor neurons are affected.

in the nervous systems of our patients. We may change resistance to test pressure by harnessing segmental synergists and antagonists. We may change resistance by affecting descending pathways. Right sided effects may be best produced by increasing afferent stimulation from the left: light, sound, stretch, etc., may be helpful. Cognitive types of activities may be used such as visualization, or specific left or right brain activities. In Dallas, at the Modules in Neurology taught by Prof. Carrick, I have been privileged to witness the use of many creative applications using these pathways to change ventral horn cell function. Rather than use volitional muscle testing to determine ventral horn cell activity, he often uses EMG. It is an effective tool particularly when there is such poor muscle activity that our standard AK testing modalities cannot be utilized, such as in paralysis, motor neuron disease., etc We have watched the EMG oscilloscope as muscle activity increased when a spinal cord injury patient was asked to contract the reflexlyassociated muscles on the contralateral (“good”) extremity while visualizing “normal” activity of the injured nerve/muscle pathway. We have seen an immediate decrease in abnormal ventral horn cell activity and fasciculations in a group of upper extremity muscles when a patient diagnosed with a potentially fatal motor neuron disease was asked to perform specific eye movements to harness pathways associated with ventral horn cell function.

The therapeutic applications available to us, whether we call it AK or Neurology, include supplying appropriate environmental stimulation to the patient to allow for the best function of his/her nervous system. Whether we test a muscle manually or stick EMG WHAT THIS MEANS TO needles into it, the immediate changes we APPLIED KINESIOLOGISTS witness are reflective of changes in nervous system function. To be neurologically correct The good news about all of this is that as we say that muscle testing is examining AK practitioners we may learn to harness the ability of the muscle to resist the test these pathways to effect positive changes pressure and represents the ability of the 23

specific segmental activity to occur as it is modulated by suprasegmental activity. And whatever therapeutic modalities we choose, if we monitor the autonomic nervous system for indicators of increased or decreased sympathetic and parasympathetic activity as discussed in the previous articles, then we may be certain that our corrections will serve the patient in the long run. We are fortunate in AK that we have trained ourselves to interpret the ability of a muscle to resist test pressure and we therefore may monitor the effects of stimulations we give to an individual. We must guard against simple explanations as to how that stimulation affected the muscle, however. There are many integrated factors and we must realize that a single muscle test is associated not only with the stretch we place upon the muscle, but the position and activation of muscles reflexogenically associated with our test muscle and the summative effect of all descending influences – the sound, light, smell, temperature and cognitive environment of the patient as well. Rubbing a point activates certain pressure receptors, but also has a cognitive effect, perhaps an emotional effect, a visual effect as the patient moves his or her eyes to follow you, etc. A muscle which gets stronger may do so as a consequence of any of these inputs – probably as a consequence of all of them acting together upon pools of neurons which impact the summative capacity of the ventral horn cell. AK works, but we need to appreciate that testing a muscle and the response to sensory stimuli as determined by changes in muscle testing is multifactorial.

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History of Applied Kinesiology George Goodheart, D.C. Applied kinesiology is the child of the inquisitive mind of George Goodheart. In the early 1960's, he began to research the causes and effects of muscular weaknesses. Each year new and important findings have been added to the body of knowledge known as applied kinesiology by Dr. Goodheart.

ICAK The International College of Applied Kinesiology was formed in 1976 to advance the study of applied kinesiology in health care professionals. There are chapters around the world with members in all professions.

Developmental Milestones High points in the development were:

1964 first book on muscle testing 1966 neurolymphatic research 1967 neurovascular research 1969 basic cranial motion-corrections 1970 basic acupuncture relationships 1973 fascial technique 1974 therapy localization 1976 temporomandibular joint corrections 1980 PRY technique 1982 strain counterstrain 1988 spondylogenic reflexes 1998 myogelosis 2003 anatomy trains

Since 1964, over 40 different treatment options have been found. Added to this are special tests that allow the doctor to test the patient using tools like muscle testing, range of motion, tenderness, challenges and others that allow accurate diagnosing of exactly what procedures are indicated for a specific patient.

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Strain Counterstrain This condition will create areas of pain similar For multiple trigger points, test for the need in nature to those described by Travell in her of glycine or folate. books and articles on myofascial pain. The major difference between the two lies in the type of treatment needed to alleviate the pain pattern. Jones’ procedure is based on trial and error to determine if his procedure of postural positioning is indicated. Goodheart has devised a system for evaluating the muscles to determine if Jones’ procedure of static positioning is indicated. The area of trigger point tenderness must be located by palpation. Check for fascial involvement by stretching the muscle that is associated with the region found and correct any imbalances. Check for fascial involvement by stretching the muscle and retesting for weakness. If weakness is found, treat accordingly. Fully contract the muscle by having the patient approximate the origin and the insertion as far as possible, and retest the muscle for weakening. Weakness found after this procedure indicates a need for the strain - counterstrain technique. Strain - Counterstrain Procedure While palpating the tender trigger point, the parts of the body where the trigger point is located will be positioned so that the greatest reduction in tenderness is achieved. As a general rule, if the trigger point is on the front of the body, the body part will be placed into flexion. If the trigger point is on the posterior aspect of the body, extension will be employed. The farther from the midline that the trigger point is located, the more rotation will be needed to reduce the tenderness. Using Jones’ procedure, this position is held for up to 180 seconds for alleviation of the trigger point pain. Goodheart suggests that while the position is being held, a stretching of the spindle cells in the belly of the muscles be done. This will decrease the length of time that the position must be held. 26

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Fascial Technique Fascia are sheets of avascular, transparent, elastic connective tissue covering and encasing Multiple muscles showing a need for fascial each muscle and visceral organ. By connecting technique are a good indication of need the of together, fascial tissues subdivide the body B-12 supplementation. into functional units. Normally, the fascia and underlying muscle should be the same length. This allows the two to function as an integral unit. If the fascia shortens in relationship to the potential length of the muscle, it creates a neurological imbalance in the control of the muscular contraction. Janet Travell, M.D. researched fascial problems for over 40 years. She wrote a two volume set on the effects of trigger points and fascial problems. Unfortunately, she had no diagnostic test except the areas of complaint of the person and the finding that if you irritated a trigger point is would sometimes cause referred pain to specific areas. Goodheart found that if a strong muscle was stretched and it weakened, it would respond to the treatment options that Travell advocated. Here is his procedure: Test a muscle for strength and if weak strengthen by normal means. Stretch the muscle to its normal limit of motion. If the muscle is a weight bearing muscle, this is done slowly. Non-weight bearing muscles are tested by stretching the fibers quickly. After stretching, the muscle is quickly retested for weakening. If found weak, involvement of the fascia is diagnosed. Utilizing a hard heavy pressure, “iron out” the fascia using pressure in the line of the underlying muscle fibers. Massage from either the origin towards the insertion or from the insertion towards the origin. B-12 in low dosages, with the associated stomach and liver extracts which supply the intrinsic and extrinsic factors, is many times indicated. 29

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Five Factors of the Intervertebral Foramina

By 1970, George Goodheart had determined that six major imbalances or defects in the body could cause muscular weakness and accompanying organ malfunction. One of these was a nutritional imbalance and was therefore a chemical cause. The others were structural problems and have been labeled the “five factors of the IVF”.

body, and at least one of these five factors will be functioning abnormally. According to Dr. Goodheart, at each intervertebral foramina there is:

1. a nerve 2. a blood vessel 3. a lymphatic vessel cerebrospinal fluid Alterations in the chemical, emotional or struc- 4. an acupuncture meridian connector tural homeostasis of the body will be manifested 5. by weakness in the muscle structure of the Malfunction of any one of the above can and does cause a weakness to occur in the body.

Nerve N

Acupuncture Meridian Connector

Neurolymphatic Reflex

AMC

Cerebrospinal CSF Fluid (Cranial - Sacral Fault)

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NV

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Muscle Proprioceptors This technique is indicated in any traumatic injury. Spindle cells are found in nearly all muscles and are more numerous in the muscles of the limbs than those of the trunk. They are located throughout the muscle, but are more concentrated in the center portion of the muscle. Because the long axis of the spindle is parallel with the long axis on the muscle, it is stimulated by stretch. This results in nerve impulses in the afferent nerve fibers. These specialized cells are responsible for informing the brain on the degree of stretch that the muscle is under.

Most tendons are supplied with stretch receptors which are located near the attachment of the muscle and the tendon. Tension on the tendon distorts these receptors stimulating them. They are called golgi tendon organs or GTO’s. Stimulation of stretch receptors in a muscle reflexly excites contraction of the muscle while stimulation of stretch receptors in the tendon inhibits the contraction of the muscle.

Pressure applied against the tendon towards the origin or the insertion of the muscle has the effect of weakening or inhibiting the function of the muscle. Pressure applied against the Pressure, applied as to approximate together tendon is a direction towards the belly of the the fibers of the muscle in its linear length, muscle, as if to lengthen the tendon, has the has the effect of relaxing or weakening the effect of strengthening or increasing the force muscle. Pressure, applied as to stretch the of contraction of the muscle. muscle fibers, has the effect of increasing the strength of a muscle.

To turn down and weaken a muscle press the spindle cells together and push towards the origin and insertion at the tendons.

To turn up and strengthen a muscle pull the spindle cells apart and push towards the belly of the muscle at the tendons. 33

Reactive Muscles This refers to the weakening of a muscle following testing of another muscle. This weakness occurs because of improper proprioceptor communication between the related muscles. A suspected muscle is tested to determine if it is strong. If the muscle is found to be weak, treat it in the normal fashion. Test a related strong muscle, for example a synergist to the original muscle, and then quickly retest the original muscle. If the reactive pattern is present, the original muscle will now test weak. Treat the spindle cells of the muscle that when tested caused the weakening of the original muscle. The spindle cells are stimulated as if to weaken the muscle. Imagine that the muscle is set too strong and therefore over powers the second muscle creating the weakness. Retest the muscle testing sequence to make sure that the muscle stays strong after treating the spindle cell. In today’s language, these reactive muscle patterns fall under the heading of proprioceptive neuromuscular facilitation problems. In the hands of athletic trainers and physiotherapists, patterning is done to normalize these spindle cell imbalances done in a global way around the joints in question. This method requires 15 - 20 minutes of “patterning” for this to occur. Using the Goodheart - applied kinesiology method, this can be done more specifically and faster.

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Muscle Interlink This term is used to describe the relationship of muscles that interact as reactive muscles in a pattern similar to that of the ligaments in the ligament interlink condition. There appears to exist a correlation between the opposite muscle groups on a joint basis. For example, the biceps relate to the opposite quadriceps, the hamstrings to the opposite triceps, etc. Treatment involves correcting the spindle cell mechanism (testing and treating as for reactive muscles). This simple observation of muscle findings opened the door for other techniques to both examine and treat gait patterns.

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Spinal Extensor Muscle Weakness Pattern

On standing, weight causes a spreading of the interphalangeal joints of the feet and a stretching of the interosseous muscles.

sertion to correct the golgi involvement.

The proprioceptors of the feet then cause an inhibition of the spinal extensors when they are stretched sufficiently.

This condition is found frequently in chronic back patients.

In Understanding the Scientific Basis of Human Movement, O’Conner and Gardner describe the reflex from the proprioceptors in the plantar muscles and joints that cause this extensor inhibition pattern. This pattern is easily demonstrated by testing a strong spinal extensor like the upper trapezius, middle trapezius or latissimus dorsi and having the subject lean forward loading the metatarsal arch. At one point, the muscle will become inhibited and explains why swimmers or sprinters commonly fault at the starting line. Observe the patient standing. Visually draw a vertical line extending down from the external auditory meatus. This line should bisect the shoulder, the acetabulum and the external malleolus. If this alignment is not found, test an extensor muscle of the spine. The mid-trapezius, upper trapezius or the neck extensors are easily tested. If weakness if found, have the patient remove the weight from the foot on the side being tested and retest the prior weak muscle. If the plantar muscles are in a state of hypertonicity, then the muscle will test strong and weak again if the weight is reapplied. Treat by correcting the spindle cell and golgi apparatus that are involved by applying pressure towards the center of the muscle in the belly, to correct the spindle cell, and by pulling away from the belly on the origin and in36

Miscellaneous

If the patient is prone, squeezing the foot will cause weakening of the gluteus maximus, hamstrings, and the neck extensors.

In treating common ache or pain patterns that patient’s present, there are three major options that can be used. The two most common in applied kinesiology involve finding the specific muscles that are over contracting causing the abnormal inhibition pattern. The third option is using a PNF (proprioceptive neuromuscular facilitation) procedure that generally addresses normalization of these

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aberrant muscle patterns. The PNF procedure requires prolonged patterning to coordinate the muscle function. In all cases, examination and correction of a related spinal imbalance significantly aids in a more permanent correction.

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Aerobic / Anerobic Muscle Testing Aerobic Muscles These are slow-firing muscles like the dark meat of turkey. They exhibit great elasticity and great endurance. They are fueled by oxidative metabolism of fats. Myoglobin holds the oxygen in the muscle for the oxidative process. Anerobic Muscles These are fast-firing muscles like the white meat of turkey. They are less elastic and fatigue easily. They are fueled by the consumption of sugars in the Kreb’s cycle. They depend upon large glycogen storage. Test for and correct muscle weakness, if found, in the normal fashion.

In scoliotic patients, examine and determine which muscles are not supporting the spine, as they should. A common finding is a unilateral weakness of the psoas. Many times these muscles will test strong on a single test. Retest using the aerobic type of repeated testing and usually the psoas, for example, will show weakness. After correcting the lymphatic reflexes, the spine will many times show a dramatic change.

Use of these types of muscle tests can aid in For aerobic muscles, the muscles of support the establishment of an effective rehabilitaretest in a rhythmic, slow repetitive manner. tion program. Determining the number of repetitions that can be performed before the Do this testing at least twenty times. muscle fails sets limits on the number of repIf weakness occurs, treat the neurolymphatic etitions that are positive for the patient. reflexes and test for the need of iron to replenish myoglobin levels. For anerobic muscles, the fast-firing muscles of the upper extremity, retest in quick, rapid succession at least twenty times. If weakness occurs, treat the neurolymphatic reflexes and supplement with pantothenic acid to augment the breakdown of glycogen in the Kreb’s cycle. If the muscle tends to cramp during the testing procedure, have the patient hold the neurolymphatic reflex. This will many times increase the blood flow and prevent the cramping.

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Muscle-Organ/Gland Association By David Walther, D.C., DIBAK Excerpted from Synopsis – Systems DC Pueblo CO 1988 Early in applied kinesiology Goodheart detected some consistency of specific muscle dysfunction with specific organ or gland dysfunction. For example, when the pectoralis major (clavicular division) muscle tested weak, there was often stomach dysfunction. When the quadriceps muscles tested weak, there was often small intestine dysfunction. When the tensor fascia lata tested weak, there was often colon dysfunction. (The complete muscle-organ/gland association is included in the muscle testing section of this text.) The observation of muscle-organ/gland association was strengthened as new examination and therapeutic approaches were introduced into applied kinesiology . Treatment to Chapman’s reflex for the stomach, now called a neurolymphatic reflex, strengthened the pectoralis major (clavicular division) muscle. Treating the neurolymphatic reflex for the small intestine improved quadriceps muscle function, and the colon neurolymphatic reflex stimulation strengthened the tensor fascia lata muscle. The Bennett reflexes, now called the neurovascular reflexes, had a similar correlation. Stimulating the small intestine reflex improved the weak quadriceps muscles. Treatment to the colon reflex improved the tensor fascia lata muscle when it had previously tested weak. A similar correlation was found in the neurovascular reflex treatment that improved function of the pectoralis major (clavicular division) muscle. It was discovered that stimulation of Bennett’s emotional reflex affected the pectoralis major (clavicular division) muscle. Reflecting that emotions are often considered as the cause of stomach problems, especially ulcers, one can readily see a tie-in.

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The next factor introduced into applied kinesiology with specific organ/gland association was the meridian system. When treatment was applied, the stomach meridian improved the pectoralis major (clavicular division) muscle, the small intestine meridian improved the quadriceps muscles, and the large intestine meridian improved the tensor fascia lata muscle. The muscle-organ/gland association of applied kinesiology is clinically valuable in helping find the primary areas of dysfunction when combined with other diagnostic disciplines. The muscle-organ/gland association should not be considered absolute. For example, there may be local muscle dysfunction causing the quadriceps muscles to test weak, with no dysfunction in the small intestine. On the other hand, an individual may have a gastric ulcer confirmed by radiology but the pectoralis major (clavicular division) may not test weak. As one becomes more advanced in applied kinesiology, it is seen that nearly always there is dysfunction of the pectoralis major (clavicular division), but the body has many ways of adapting to dysfunction. With advanced applied kinesiology techniques, it may be found that the pectoralis major (clavicular division) muscle tests strong in the presence of an ulcer because there is over activity of the stomach meridian as an adaptive healing effort by the body. Research on the muscle-organ/gland association is ongoing, with much yet to be learned. 1, 2, 3, 4, 5, 6 1 Burdine, C., “The reactivity of muscle strength to visceral stimulation and neurolymphatic point pressure.” Independent Research, unpublished, University of Illinois, Jun 1982 2 Carpenter, S.A., J. Hoffman & R. Mendel, “An investigation into the effect of organ irritation on muscle strength and spinal mobility,” Thesis, Anglo-European Coll Chiro,

Bournemouth, England, 1977 3 Corneal, J.M. & R. Dick,”An attempt to quantify muscle testing using meridian therapy/acupuncture techniques” Proceedings of Winter Meeting, ICAK Palm Desert, CA, 1987 4 Jacobs, G.E., T.L. Franks & P.G. Gilman,”Diagnosis of thyroid dysfunction: Applied kinesiology compared to clinical observations and laboratory tests,” J Manip Physiol Ther, Vol 7, No 2 (Jun 1984) 5 Leaf, D.W., Nutrient Testing Evaluation” Proceedings of Summer Meeting , ICAK, Santa Monica, CA 1985 6 Wing, T.W., “Applied kinesiology, related organs, meridians, and auricular therapy,” Chiro Econ, Vol 21, No 4 (Jan/Feb 1979) .

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Introduction on Applied Kinesiology and Nutrition By David Walther, D.C., DIBAK Excerpted from Synopsis – Systems DC Pueblo CO 1988

about nutrition may provide seven, eight, or even ten diverse philosophies leading to different therapeutic approaches, or perhaps to no treatment at all. Extremes range from A system for evaluating nutritional effects on the belief that if a person eats balanced body function has been developed in applied meals no nutritional supplements are ever kinesiology by Goodheart. 28, 29 The system needed to recommendations of so many appears to provide additional information high-potency supplements that one would about how nutrition, or possibly adverse hardly need eat regular food, except for fiber. substances, may work with or affect body Philosophies about nutrition vary from megafunction. It is designed for use in conjunction dosages of numerous supplements to lowwith the physician’s general knowledge potency products of natural origin only. Some of nutrition, and laboratory and physical recommend that specific nutritional products diagnostic findings. It is important that the routinely be given with certain medications examiner using this technique be thoroughly to offset any side effects1, others recommend knowledgeable about the usual methods for no medication, with nutrition taking its place; determining nutritional needs. still others recommend minuscule dosages of homeopathic remedies for the treatment Applied kinesiology nutritional testing of disease. There are vitamins, minerals, appears to reflect the nervous system’s isolation of natural food products (such as the efferent response to the stimulation of the essential fatty acids), herbs to treat almost gustatory and olfactory nerve receptors by any condition, and Bach flower remedies for various substances. The nerve pathways mental and emotional conditions. 2, 3, 4 causing change in muscle function as observed by manual testing are unclear; Why are there so many philosophies with however, there is considerable evidence in different treatment approaches to something the literature of extensive efferent function as essential to our life as the food we eat? throughout the body from stimulation to The answer cannot be put into a simple the gustatory and olfactory receptors. There statement. There are many reasons for the is also evidence of afferent modification of confusion that reigns among nutritional gustatory sensitivity and central nervous authorities. Paramount among these is that system interpretation of gustatory impulses all nutritional factors have not even been ultimately modifying functional change as a discovered yet, and it is not known exactly result of oral stimulation. Applied kinesiology how the body uses many nutritional products. nutritional testing enables a physician to give As we progress with our discussion, keep in individual consideration to each patient’s mind that the first description of treating nutritional needs. To properly apply this scurvy with ascorbic acid was done only fifty method of testing, one should be thoroughly years ago, by Parsons. 5 familiar with the nervous system’s role in nutrition, and also be proficient in manual The applied kinesiology method of evaluating muscle testing. changes in body function as the result of nutritional stimulation fills a specific void As one begins a serious study of nutrition in the question of nutritional deficiency outside applied kinesiology, it is easy to diagnosis. The method consists of stimulating become very confused. Consulting ten the gustatory or olfactory nerve receptors different authorities on specific questions by having the patient chew or inhale30 the 43

substance to be evaluated, and then manually testing a muscle for change. The muscle may appear stronger or weaker, depending upon the type of evaluation being made and the muscle’s neurologic association with the substance stimulating the nerve receptors. This system of testing is controversial. One reason for this is that there have been many modifications of Goodheart’s original description. Some, rather than have the patient stimulate the gustatory or olfactory receptors with the substance being tested, have the individual hand-hold the substance or lay it on the belly; some even have the patient hold a bottle containing the substance to be tested. 6, 7, 8, 9, 10 These modified systems are frequently taught to lay people 6, 7, 8, 11, 12 who often do not have the anatomical knowledge necessary for accurate muscle testing, nor do they have a nutritional background or general diagnostic ability. The testing of nutrition as advocated by the International College of Applied Kinesiology is a discipline limited to stimulating the gustatory or olfactory nerve receptors with the substance to be evaluated, combined with accurate and specific muscle testing. The information derived from these tests must then be correlated with a standard diagnostic work-up by a person licensed in the healing arts to be a primary health care provider. The approach discussed in this text is designed to be an adjunct to standard nutritional evaluation, not to take the place of it. Those who have the expertise to properly test nutrition, as described by the ICAK, should not use this method as a sole approach in evaluating nutrition and/or substances harmful to the body. This writer believes that the modified testing procedures for nutrition - including handheld, laying it on the skin, touching various areas of the skin, and teaching the material to lay people - may lead to errors in diagnosis and are potentially detrimental to the health of the subject being evaluated. The abuses of manual muscle testing in 44

evaluating nutrition have sunk so low that this writer once heard a woman at a nearby table in a restaurant say, “If you don’t believe me, let me show you.” She then had a man at the table stand up and hold a sugar dispenser in his hand. She proceeded to have him hold his other arm out and attempted to pull it down. He was a strong individual, and she almost lifted herself off the floor before she was able to pull his arm down. Then came the statement, “See - I told you it would make you weak.” Applied kinesiology nutritional evaluation is indeed a revolutionary method of determining nutritional needs. In my twenty-seven years of practice, I have seen many changes take place in what is considered the routine nutritional approach for health problems. Twenty-five years ago I was increasing fiber content in the diet of patients with colon disturbances. On three different occasions when I took patients off the bland, refined carbohydrate diet prescribed by their allopaths, I was called a stupid quack and accused of endangering the lives of my patients. Fortunately, the patients continued my therapeutic approach and had uneventful recoveries, in spite of the diatribe against me and my procedure. Today, even television commercials and the National Cancer Institute13 emphasize the need for fiber in the diet. Those same doctors who called me a quack now use the approach I used twenty-five years ago. There are many reasons that nutritional needs should be evaluated on an individual basis. Applied kinesiology adds to the physician’s nutritional knowledge the ability to determine, to a certain extent, the effects of various nutritional products on the specific individual being considered. Furthermore, it enables one to evaluate the difference between nutritional products that may appear to be the same according to the product’s descriptive label, but act differently from individual to individual. People are different. Everyone does not require the same nutritional program

regarding the food eaten and possible supplementation taken. Williams14 points out that researchers must begin considering biochemical individuality in the study of nutrition. Individuality may have a genetic basis with different body composition, enzymatic patterns, and endocrine balance. Williams presents a hypothetical group of ten men (group 1), all of average height, with the same foot size. They have the same amount of hair on their heads, and an average tendency to put on body fat. They consume the same amount of alcoholic beverages, have the same sex urges, and their digestive tracts react the same to food. They all have normal teeth, without cavities or plaque buildup. Finally, they all have the same emotional reactions to the same daily stresses.

body wisdom was adequate in regulating food intake to an less than 1/20 of 1%. There is abundant data indicating that man and animals have innate self-selections to determine quantities and quality of food that will provide optimal health. Although this mechanism is constantly functioning to some degree and will be discussed later, it is not an answer to the nutritional question; there are many factors that interfere with proper selfselection.

In-depth study of nutrition is done to indicate the nutritional products needed for optimal health and for the treatment of various types of body dysfunction and disease processes. Why do many of the studies end with opposing conclusions? If complete data is available, one may find that one study used a natural vitamin Contrast this group with another hypothetical product while the other used a synthetic one. population of ten men (group 2). In this One may have used a higher potency vitamin group is one man who has lost all his hair. than the other, or the studies were biased by Another seems to gain weight just by thinking group selection. Conflicting conclusions may about food. Another has long, narrow feet be traced to the differences in manufacturing and fingers. One supervises 100 men on a nutritional products. One company may use production line, with a very tight productivity heat in processing, and another cold. Keep in schedule to meet. Another has no sex drive, mind that all nutritional cofactors have not and still another is a salesman with his two- yet been discovered. martini lunch schedule. Applied kinesiology nutritional testing, It seems that the minimum and maximum like the other considerations, is not alldaily requirement of nutritional complexes encompassing and must be correlated with can be easily figured for group 1, but what are other methods to determine nutritional need. the needs for group 2? If there is considerable In a status statement published in 1983 15, individuality among people, how has man 16 and updated in 1988, the International survived for so long before there was any College of Applied Kinesiology states, study of his nutritional needs? Is there an “Nutritional and chemical evaluation [by innate self-selection of the food needed by the muscle testing] should only be done with the body? Williams points out the body’s wisdom substance stimulating the subject’s olfactory with the illustration of an individual who has or gustatory receptors. It is also necessary no knowledge about nutrition and little or no to evaluate other factors that may influence tendency to gain weight. If, during a ten-year the perceived muscle strength. Confirming period, he gains five pounds, his self-selection diagnostic criteria for the need of any of food has regulated his caloric intake to a nutrition should be present from the patient’s minimum error. During this period, if he were other diagnostic work-up, which may include moderately active he would have consumed history, type of dysfunction, laboratory tests, approximately 12,000 pounds of moist food. physical diagnosis, and dietary inadequacies. If there was a 1% error of caloric intake over . . . An adequate educational background is the ten years, he would have gained or lost needed in evaluating nutritional needs and 120 pounds. With the five-pound gain, his 45

manual muscle testing. The use of manual muscle testing by lay salespeople has created The primary method of testing nutrition in problems due to their untrained nature and applied kinesiology is to have the patient chew enthusiasm to sell their products.” the substance to be tested. The influence on the Some have described the testing of nutrition by body appears to be the result of stimulating manual muscle testing as a simple procedure, the gustatory and olfactory receptors. Oral 8, 9, 11, 12 which it certainly is not. One must be absorption may also influence the body. aware of the various factors that influence manual muscle testing, such as subluxations, In simple daily observation, one can see many lymphatic drainage, intrinsic neurologic instances in which chewing nutrition quickly dysfunction, balance of the meridian system, changes an individual. A hungry, crying child and function of the cranialsacral primary quiets immediately upon nursing or obtaining respiratory system. These are only a few of other food. An irritable hypoglycemic the many factors that have been found to individual calms immediately upon chewing influence the manual muscle test. They must food, long before there can be any rise in the be taken into consideration when evaluating blood sugar level from the substance. an individual for his nutritional needs. The importance of the gustatory system on Nutritional testing with the modified methods health is illustrated in a report by Pangborn of holding the nutrition in the hand, laying 19 about a Russian study by Murskii wherein it on the body, holding a bottle that contains dogs were “killed,” then resuscitated. Early the substance, and touching various “reflex recovery of the gustatory function was always points” about the body is often the main subject associated with successful resuscitation. of a book or booklet produced for general In cases where recovery was difficult and public reading. In some instances, these cortical cells did not regain full function, the procedures are taught at weekend seminars ability to distinguish food from non-foods was that may be sponsored by companies trying to sometimes disturbed. The early development sell their nutritional products. In fact, some of taste sensation emphasizes the importance nutrition companies have taught lay people of gustatory function. The newborn human to do muscle testing to convince prospective infant is able to distinguish water from customers to buy the product. When one tries sugar solutions. 20, 21 Fetal sheep can taste, to “prove something” to another individual as measured at the chorda tympani nerve, with manual muscle testing, errors often as early as 100 days into the gestation period result. The examiner may unconsciously (term = 147 days).22 change the parameters of the test (or may not even know what the parameters are), and When chewing nutrition changes muscle make the test come out the way he expects function as perceived by the manual muscle due to his enthusiasm for the procedure.17 test, the change is almost immediate. It seems In no way should the modified procedures be evident that the effect is due to stimulation confused with applied kinesiology methods. of the gustatory and olfactory receptors. Oral The skilled applied kinesiologist uses manual absorption of some of the chewed material muscle testing to evaluate nutrition as an may stimulate remote receptors. As will be adjunct to standard laboratory and physical discussed later, certain substances enter diagnostic methods. All factors of the the bloodstream almost immediately by oral examination should correlate, or something absorption. is being missed. Research sponsored by the ICAK 18 points out that manual muscle testing Most of the research done on testing nutrition to evaluate nutrition, whether chewed or held by applied kinesiology methods has been in the hand, is not a viable approach in and of clinical correlation of muscle testing results itself. when specific nutrition is chewed, in correlation 46

with the clinical and laboratory examinations previously mentioned. The literature has many examples of how gustatory receptors and oral absorption change body function. Research shows widespread interaction within the nervous system and the body in general from nutritional stimulation. Most of the research discussed here was done prior to the clinical knowledge of the effect chewing nutrition has on manual muscle testing. Further research must be done, taking into consideration the influence of nutritional products on the nervous system and the great amount of neuromuscular, organ, and gland interaction. Most of the basic research has been done on the control of food and water intake under normal and abnormal conditions. There have been group and isolated studies done on innate self-selection and its effect on health and diseased states. While these studies have nearly all indicated that self-selection enhances health, we will also consider how education, environment, emotions, and status satisfaction override proper innate self-selection.

How a substance tastes to an individual does not appear to have any bearing on applied kinesiology nutritional testing. The results of the test appear to depend on how the nervous system reacts physiologically to the substance. The sensation of taste as subjectively evaluated by the subject is a hedonic one and appears to be evaluated on another level. 26 The attractiveness of food, its texture, and an individual’s previous experience playa major role in what he chooses to eat. A fresh apple is identified as such by its odor. Peel and mash a raw apple and a potato to eliminate the texture characteristics. It will be difficult to determine which is which when each is tasted with the nose and eyes closed. Cold milk, beer, and soup are distinctly different in taste from hot milk, beer, and soup. One easily recognizes the optimal temperature of wine or meat. Changing the visual stimulation of the food by adding tasteless food coloring increases or decreases its attractiveness. Try serving blue-yolked eggs or black cereal! The change in desire is due to a learned response, not the dark color, since black caviar and olives rank Progressive research on applied kinesiology among the most desired delicacies. nutritional testing should not be limited to the gustatory receptors. Food and water intake Stimulation of the gustatory receptors elicits is regulated by a combination of peripheral specific preferences in drinking or eating or - on and central systems. Stevenson 23 presents an the other hand - in rejecting particular foods. overview of this integration. Chemoreceptors, Pfaffmann, 27 in discussing the “pleasures of such as the glucoreceptors in the hypothalamus sensation,” emphasizes the hedonic aspects and liver and liporeceptors monitoring the of sensory stimulation and suggests that fat deposits, provide information about the sensory input to the hypothalamus and body’s reserves. It has been suggested that other structures of the limbic system may be glucoreceptors provide a short-term control involved in hedonic and reinforcing features of food intake relative to immediate energy of stimulation, as compared with cognitive needs, while the liporeceptors provide a long- and arousal functions. Some items tested term control for the maintenance of body with applied kinesiology methods fit into weight. Additionally, the osmoreceptors, the pleasurable realm, while others are stretch receptors, and baroreceptors reflect distinctly unpleasurable. Typically, sugar blood volume and extracellular fluid will cause a hypoadrenic individual to test volume. Even thermoreceptors playa role in weak on its ingestion, while a vile-tasting regulating food intake. It is well-known that product for adrenal supplementation will the environmental temperature influences cause a previously weak associated muscle food intake in man and animals. Hypo- or to strengthen. Those who use manual hyperactivity of endocrine glands, such as muscle testing to evaluate nutrition should the thyroid 24 and adrenal,25 modifies taste be thoroughly familiar with the nervous system’s role in nutrition. Although much of sensation and reaction to stimulation. 47

the basic research was done prior to the use of manual muscle testing to evaluate nutrition, it provides a foundation for further basic and clinical research to understand the action taking place. 1 Roe, D. A., Drug Induced Nutritional Deficiencies : (Westport, Ct: Avi Publishing Co. Inc. 1976) 2 Adolph, E. F., Urges to eat and drink in rats,” Am J Physiol, Vol 151 (1947) 3. Chancellor, P. M., ed, Handbook of the Back Flower Remedies (London: The C W Daniel Co Ltd. 1971) 4 Weeks, N. The Medical Discoveries of Edward Bach, Physician (New Canaan, Ct. Keats Pub. Inc. 1979) 5 Parsons, L. G., “Scurvy treated with ascorbic acid,” Clin Orthop, No 222 (Sept 1987) 6 Barton, J.E., How to take Care of yourselves – Naturally (Medford, OR: Harman Press, 1977 7 Barton, J. E. & Barton, M., Which Vitamin? Nutritional Care through Muscle Testing ( E. Longmeadow, MA: Celecom Corporation, 1979) 8 Fischman, W., & Grinims, M. MRT (New York: Richard Merk Publishers, 1979) 9 Peshek, R. J., Balancing Body Chemistry with Nutrition (Riverside, CA: Color Coded Systems, 1977) 10 Peshek, R. J., ed, Nutrition for a Healthy Heart – for the Treatment of Pain ( Riverside, CA: Color Coded Charting, 1979) 11 Sheinkin, D. M., Schacter & Hutton, R., The Food Connection ( Indianapolis: The Bobbs-Merrill Co. 1979) 12 Thie, J. F., Touch for Health, revised ed (Marina del Rey, CA: DeVorse & Co., 1979) 48

13 Wynder, E. L., “ Cancer Prevention,” in 1981 Medical and Health Annual, ed E. Bernstein (Chicago: Encyclopedia Britannica, 1980) 14 Williams, R. J., Biochemical Individuality – the basis for the Genetotrophic Concept (Austin, TX: Univ of Texas Press, 1956) 15 International College of Applied Kinesiology, “Applied Kinesiology – Adopted Status Statement of the ICAK,” Chiro Econ, Vol 26, No 3 (Nov/Dec 1983) 16 International College of Applied Kinesiology, “Applied Kinesiology – Status Statement of the ICAK,” Am Chiro (Jan/Feb 1984) 17 Schwrtz, J. P., “Some dangers in the development of new techniques in applied kinesiology.” Proceedings of Winter Meeting , ICAK, St. Maarten, 1980 18 Triano, J. J., Muscle strength testing as a diagnostic screen for supplemental nutritional therapy: A blind study,” J Manip Physiol Ther, Vol 5, No 4 ( Dec 1982) 19 Pangborn, R. M., “Some aspects of chemoreception in human nutrition” in The Chemical Senses and Nutrition, ed M.R. Kare & O. Mailer (Baltimore: The Johns Hopkins Press, 1967) 20 Mailler, O.,& Desor, J. A., Effect of taste on ingestion by human newborns,” Oral Sensation and Perception – Development in the Fetus and Infant, ed J.F. Bosma (Bethesda: U.S. DHEW, 1973) 21 Nisbett, R. E., Gurwitz, S. B., “Weight, sex and the eating behavior of human newborns,” J Comp Physiol Psychol, Vol 73, No 2 (1970) 22 Bradley, R.M., & Mistretta, C.M., “Investigations of taste function and swallowing in fetal sheep,” in Oral Sensations and Perception – Development

in the Fetus and Infant, ed J.F. Bosma (Bethesda: U.S. DHEW, 1973) 23 Stevenson, J.A.A., “Sensory mechanisms and multi-factor regulation of food and water intake,” Ann NY Acad Sci (May 15, 1969) 24 Hoshisima, H. et al., The mechanism of insulin secretion after oral glucose administration, “Diabetologist, Vol 8 (Apr 1972) 25 Fregly, M.J., “Specificity of the sodium chloride appetite of adrenalectomized rats; substitution of lithium chloride for sodium chloride, ”Am J Physiol, Vol 195, No 3 (Dec 1958) 26 Kare, M.R., “Some functions of the sense of taste,” J Agr Food Chem, Vol 17, No 4 (Jul/ Aug 1969) 27 Pfafmann, C. “The pleasures of sensation,” Psych Rev, Vol 67, No. 4 (1960) 28 Goodheart, G. J., Jr., The Cranial Sacral and Nutritional Reflexes and Their Relationship to Muscle Balancing ( Detroit: privately published, 1968 29 Goodheart, G.J., Jr., “Structural imbalance and nutritional absorption ( a new route to the brain),” Chiro Econ, Vol 13, No 3 (Nov/Dec 1970) 30 Brimhall, J.W., “Inhalation therapy”, Proceedings of Summer Meeting, ICAK, Detroit, 1979

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Challenge One of the three original findings of Goodheart is the concept of challenge. Using muscle testing or other biomechanical indicators, the body is challenged for the positive or negative affects of different stimuli. In nutritional testing, substances that may be detrimental to a person can be insalivated or challenged by smelling and strong muscles will weaken or you may find increased muscle tenderness or decreases in range of motion. The same negative effects can be monitored by changes in vital capacity and/or changes in pulse rate. The challenge concept is easy to understand in relationship to muscle weakness related with nerve problems. If they muscle is weak due to a nerve entrapment, correction of the nerve entrapment will cause the muscle to strengthen. Likewise twisting, rotating or stretching the nerve may produce weakness if there is in involvement along the pathway of the nerve. Challenge can be used with either a strong muscle or a weak muscle. If you start with a weak muscle then only those factors, which are related to that muscle weakness, will cause a change or improvement in the strength of the muscle. In discussing the challenge mechanism, it is common to refer to a strong indicator muscle. This is a muscle which is strong and can easily be inhibited by using techniques such stimulating the spindle cells as to “turn down” the strength, the sedation point of the related acupuncture circuit, placing a battery over the related meridian or simply tracing the meridian in the opposite direction of its normal flow of energy to produce a temporary weakness.

Structural Challenge This is a method of testing that will determine if a vertebra, when pressed in a specific direction, can return to its normal position in a state of equilibrium. It is used to determine the direction of a subluxation of a vertebra. If a subluxated vertebra is pressed in a direction that reduces the subluxation and is held in that position, a muscle that was previously weak due to that subluxation will now test strong. When the vertebra is released, the intrinsic muscles of the spine will contract and temporarily pull the vertebra further into subluxation and any previously strong muscle will now test weak. Test and find a convenient strong muscle. A force of 1 - 3 pounds is applied is a specific vector. Quickly, within five seconds, retest the muscle and determine if the muscle has weakened. Apply pressure in any and all directions that the vertebra in question can subluxate and retest the muscle. Record all directions that cause weakness to occur. The vertebra is in a position opposite to that of any vector of force which causes a weakening of the indicator muscle. Correction must be made into the direction that caused the greatest weakness. Correction should be made on the phase of respiration that abolishes the weakness induced by the challenge. If the subluxation is chronic, check for involvement of the intrinsic muscles of the spine. If the challenge direction is straight lateral, then the rotatory brevis will be the major muscle involved. Lateral but superior direction is indicative of rotatory longus involvement, and superior-inferior directions indicate the interspinalis muscles. Pressure applied to a vertebra causes the muscles to react, opposing this motion and

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the pressure, the muscles momentarily contract, “rebounding” the atlas in a direction exactly opposite the original pressure. If the atlas For example, pressure applied to the atlas on was originally subluxated in this direction, the right lateral mass will cause the capitis the resultant rebound will cause the atlas to muscles to resist the pressure. On removing move into a position of greater subluxation and weaken a strong indicator muscle. further subluxating the vertebra. This has been termed rebound.

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Chemical

When dealing with weak muscle organ related problems, consideration must be given to the biochemical factors that are necessary for proper organ function. For example, Goodheart found that the gracilis muscle is related with adrenal cortex involvement. The adrenal cortex produces steroid hormones. Cholesterol is the basic raw ingredient. The initial cofactors that are necessary for cholesterol to transform and stimulate the biochemical pathway are niacin and or niacinamide. Other cofactors such as vitamin E and zinc are necessary to produce testosterone and estrogen. Pantothenic acid, vitamin C, folic acid and B-12 are cofactors

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necessary to produce cortisol. If the patient presents with symptoms of hypoadrenia and has a weak gracilis muscle, then questions and challenges for the above factors will help isolate those nutrients that the patient specifically needs. One interesting factor is that when the correct nutrients are introduced and chewed by the patient, related organ or muscle tenderness patterns will be dramatically reduced.

Neurolymphatic Reflexes History

These were first discovered by Frank Chapman D.O., in the 1930’s as reflexes that would affect the lymphatic drainage of specific organs in the body. His system was to treat the area associated with an organ malfunction. In 1965, Goodheart related the lymphatic reflex points to specific muscleorgan dysfunctions.

Location

There are both anterior and posterior reflexes occurring in pairs for each muscle-organ relationship. The reflexes are located over the muscles of the neck, back, chest, abdomen, and thighs.

Treatment The reflexes are contacted with a firm pressure and manipulated in a rotary fashion.

Time of treatment can vary from a few seconds to eight to ten minutes. Try not to over stimulate, as this will fatigue the point and cause the patient discomfort.

Symptoms

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Aside from the obvious symptoms of edema, whether pitting in nature or localized as in joint trauma, the following are indications of possible lymphatic congestion.

Tenderness of muscles or organs



Infections such as tonsillitis, otitis, lung infections, etc.



Weakness upon prolonged exertion, like stair climbing



Decreased organ function.

Neurovascular Reflexes History

These reflexes were first reported by Terrence Bennett, D.C., in the 1930’s, as empirical points that would affect circulation to specific organs in the body. In 1966, Goodheart related the vascular points to specific organ-muscle combinations.

Physiology

The vasomotor center is located in the lower third of the pons and the upper two-thirds of the medulla. The upper lateral sections control vasoconstriction while the rest inhibits the action controlling vasodilatation. The continuous working of these areas controls vasomotor tone. The control of vasodilatation and vasoconstriction can be influenced by higher centers in the brain, and it is through the use of the “Bennett reflexes”, somatoautonomic reflexes, that circulation is influenced.

Location

These reflexes are almost entirely located on the skull. They consist of small localized areas that embryologically have a vascular relation with the associated muscle-organ complex.

Treatment

The points are contacted with a light tugging of the skin overlying the point. Vary the direction of the contact until a maximum pulsation is felt. The rate of pulsation should be between 70 and 74 beats per minute and will vary only slightly in relationship to the patient’s heart rate. The length of time is usually from 20-30 seconds, however, thermal biofeedback work has shown the need for selected points to be held for up to five minutes.

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Partial list of commonly used lymphatic reflexes

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Lung Liver Stomach Pancreas

-

Deltoid Pectoralis sternal Pectoralis clavicular Latissimus Dorsi

Adrenals Bladder

-

Sartoirius/Gracilis Tibialis anterior

Neurovascular reflexes

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Meridian Therapy Goodheart became aware of the concepts of acupuncture from the book written by Felix Mann of England. This book outlined the basic concepts developed by the Chinese. It described the basic theories and the usage of the meridian points. This book and the one by Mary Austin formed the basis of the ideas developed by Goodheart. One of the most important sentences in the book was one that stated that every time there is a meridian imbalance there would be a spinal problem at a specific spinal level related to the median. The primary intent of the acupuncturist is to prevent sickness and disease. The doctor who treats disease is considered a secondary practitioner. The higher doctor prevents the disease. The oldest known reference is “The Yellow Emporeror’s Classic of Internal Medicine” or the Nei Ching. This was supposedly written by Huang Ti, the Yellow Emperor, who ruled from 2696 to 2598 B.C. The Nei Ching is a dialogue between Huang Ti and his minister Ch’i Po. In this discussion, the emperor poses questions and the minister branches into answers that turn into long discourses on health. Acupuncture, meridian therapy, has been practiced in China for over 5,000 years. The basic philosophy is that man is a small universe and the natural laws of positive and negative that control the universe also control man. Classical acupuncture consists of four basic methods of treatment: 59

1. Stimulation of meridian points to balance the energies of the body. 2. Dietary changes as well as the use of herbs. 3. Manipulation of the spine. 4. Psychotherapy through meditation and introspective analysis. Energy, chi, flows through the body in distinct pathways called meridians. Chi is defined as the energy of life. Without it, we are dead. Chi has a positive, yang, nature and a negative, yin, nature. Both aspects of chi are essential to health, but a delicate balance must be maintained between them. Imbalances, in the meridian system, result in too much chi in one meridian and too little chi, energy, in one or more meridians. Imbalances can arise from dietary imbalances, trauma, environmental factors, seasonal changes, or emotional upsets. Imbalances of energy are corrected by stimulating acupuncture points on the meridian pathways and manipulating the spine at a specific spinal level. Dietary advice is also given to aid in the correction of the imbalance. There are twelve major and two minor meridians. The major ones are located on each side of the body and form a continuous pathway that energy is supposed to pass through daily. These meridians are mostly named for organs. Goodheart was able to confirm one of his prior observations, that muscles can be related with organs, by sedating a meridian and testing the muscle that he felt related to that meridian.

Meridian - Muscle Relationships The meridians are pathways that energy travels over. This energy appears to be electromagnetic as placing a battery or magnet over the meridian will "short" the meridian and the associated muscles will test weak. Research done at the National College of Chiropractic showed that there is an electrical resistance in the meridians that is related to the number of points that the Chinese believed the meridian contained. Meridian

Code

Associated Muscles

Lung

Lu

Deltoids, Anterior Serratus, Coracobrachialis

Large Intestine LI Tensor Fascia Lata, Hamstrings, Quadratus Lumborum Spleen/Pancreas

SP

Latissimus Dorsi, Triceps, Mid and Lower Trapezius

Stomach ST Pectoralis clavicular, Neck Flexors and Extensors, Sternocleidomastoid, Biceps, Brachioradialis, Supinator, Pronator Teres, Masseter, Temporalis, Internal and External Pterygoid Triple Warmer

TW

Teres Minor, Infraspinatus

Circulation/Sex Cx Sartorius, Gracilis, Gluteus Maximus, Gluteus Medius, Adductors, Piriformis, Small Intestine

SI

Quadriceps, Abdominals

Heart Ht Subscapularis Gall Bladder GB Popliteus Liver Lv Pectoralis Sternal, Rhomboid Bladder Bl Tibialis Anterior, Peroneus Longus& Brevis, Sacrospinalis Kidney

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K

Psoas, Iliacus, Upper Trapezius

Pulse Points Use

Pulse points are used to diagnose imbalances in the meridians.

Location

They are located on both wrists on the radial artery. Classically, there are 12 pulses, six on each wrist with three superficial and three deep.

Therapy Localization

One other pulse position has been found by Goodheart. This position is diagnostic for imbalances in the Vessel of Conception and the Governing Vessel. Pulse points are normally therapy localized by the patient. Pulse points can also be therapy localized by the doctor. Care must therefore be exercised, when testing the arm that no contact is made by the doctor over the pulse points. If the pulse points are contacted, erroneous information may be ascertained. When a pulse point positively therapy localizes, an imbalance may exist, in either the superficial or deep meridian. To determine which, test the associated muscle or therapy localize to the Alarm Points to determine which (or both) is involved.

Circulation/sex (S) Triple warmer (D) Stomach (S) Spleen/Pancreas (D) Lung (S) Large Intestine (D) Governing Vessel Conception Vessel

The exact points are located by having the patient touch the first point and then just slightly separate the fingers so that they do not touch. There are in classical acupuncture superficial (S) and deep (D) pulses.

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Bladder (S) Kidney (D) Gall Bladder (S) Liver (D) Small Intestine (S) Heart (D) Governing Vessel Conception Vessel

Alarm Points Location Six are singular points for both the right and the left meridians, while six

meridians have both right and left alarm points. There are also two additional points for the Governing Vessel and the Vessel of Conception meridians.

Use

Therapy localization to the alarm points will cause a strong muscle to weaken if there is an imbalance in the meridian associated with the alarm point. If a weak muscle is strengthened by having the patient contact an alarm point, then treatment of the indicated meridian will help restore normal function to the indicated muscle-organ combination. Alarm points will be tender if there is an imbalance in the associated meridian. Alarm points are not treatment points. They are strictly diagnostic points.

Cv -17 Circulation/sex Triple Warmer Superior Point Lung Lu - 1 Gall Bladder GB - 23 Secondary ----Liver Lv - 14 Gall Bladder GB - 24 Main ----Spleen/Pancreas Lv - 13 Kidney GB - 25 on back -Large Intestine St - 25

Cv - 15 Pericardium discovered by Soulie de Morant Cv - 14 Heart Cv - 12 Triple warmer Middle point (Stomach) Cv - 7 Triple warmer Inferior point Cv - 5 Triple warmer Main point Cv - 4 Small Intestine Cv - 3 Bladder

FELIX MANN MB - BChir (Cambridge), LMCC (McGill) President of the Medical Acupuncture Society

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Associated Points Location

Each meridian has an associated point on each side of the spine. The points lie between two vertebrae, and can indicate a subluxation of either structure.

Use

Felix Mann has stated in his book on Acupuncture, that every time there is a meridian imbalance, there is a spinal subluxation at the level of the associated point of the involved meridian. Goodheart confirmed this finding and also determined that a spinal subluxation can cause a meridian imbalance. Research, performed by Robert Perolman, has shown that this subluxation will be found at the level of the excess meridian. Associated points will also be tender to palpation if there is an imbalance in the associated meridian. Every time that a meridian imbalance is found, after correcting the energy flow by treating the appropriate points, the spine must be challenged and adjusted at the level of the blocked meridian and its corresponding Lovett’s vertebra.

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T3-4

Lung

T4-5

Circulation/Sex

T5-6

Heart

T 9 - 10

Liver

T 10 - 11

Gall Bladder

T 11 - 12

Spleen/Pancreas

T 12 - L - 1 Stomach

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L1-2

Triple Warmer

L2-3

Kidney

L4-5

Large Intestine

S-1

Small Intestine

S-2

Bladder

Category II Pelvic Subluxations Definition This refers to a sacroiliac misalignment or subluxation. The category system was first described by DeJarnette. Goodheart correlated muscle imbalances with the different possible misalignments of the pelvis. This correlates with the marking system developed by Gonstead.

Therapy localization With the patient either standing or in a supine position, the patient contacts first one sacroiliac joint and then the other and a strong muscle is tested for weakening (one hand to one joint). If this causes weakening of a strong indicator muscle, respiration can be used to help determine if the innominate is rotated. The abdominals are inhibited on inspiration. This allows medial rotation of the posterior superior iliac spins (PSIS). On expiration, the abdominals contract and the PSIS is pulled laterally. Consequently, if the positive therapy localization is changed by either full inspiration or expiration, a rotation of the pelvis is present. If the strengthening occurs on inspiration, the PSIS has moved lateral and needs to be corrected medially. If the strengthening occurs on expiration, then the PSIS needs to be corrected in a lateral direction.

Posterior Ilium - Short Leg

should be challenged and corrected including nutritional support. The pelvic misalignment can be corrected by either placing a block at the level of the crest of the ilium on the short leg side and one on the opposite side below the buttocks to raise the ischial tuberosity, and have the patient lie supine until the pelvis no longer therapy localizes or challenges with the blocks removed; or place the patient in a side lying position and adjust the ilium in the challenge direction.

Anterior Ilium (Posterior Ischium) - Long Leg Tenderness is found on the lateral thigh, the obturator foramina and the first rib attachments anteriorly and posteriorly with the anterior ilium (posterior ischium). Weakness of the biceps femoris and the vastus lateralis will be found and all associated reflexes should be challenged and corrected. Occasionally, abdominal weakness is a contributing factor. The pelvic subluxation can be corrected by placing the patient in a side lying position and adjusting the ischium or through the use of the blocks as described above. An alternate blocking procedure is to have the patient stabilize the blocks and first flex the short leg to ninety degrees and then rotate the leg away from the body and then straighten the leg. The long leg is then flexed and rotated across the body and then returned to its normal position.

Tenderness is found at the origin and insertion of the sartorius and the gracilis as Internal - External Iliac Rotation well as at the first rib head at the sternum and at the attachment of the first rib and the Positive therapy localization of the sacroiliac joint may indicate either internal or external first thoracic vertebra. rotation of the ilium. Weakness will be found of the sartorius and/or the gracilis. All associated reflexes An internal ilium may be found to be associated 65

with weakness of the transverse and oblique abdominals.

In both cases, correction is obtained by adjusting the patient in a side lying position. The direction of force is determined by An external rotation of the ilium is found challenging the ilium to determine the vector associated with a weakness of the gluteus of force that strengthens the indicator muscle medius/minimus on the same side. the most. Tenderness is found along the origin of the gluteus medius in external rotation and along the insertion of the oblique abdominals at the crest of the ilium when the innominate is internally rotated.

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Tenderness patterns First rib At both its anterior and posterior ends

Abdominal Oblique Internal rotation Gluteus medius External rotation Iliotibial band Anterior ilium Sartorius/Gracilis Posterior ilium

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Rectus Femoris Flexes the thigh on the pelvis and extends the lower leg on the femur. It is the muscle that initiates the forward motion of the femur in walking after toe off. The muscle is more active than other sections of the quadriceps in climbing stairs.

Sartorius During the swing phase of gait it contributes to hip flexion. Aids in knee flexion. Aids the prime movers of thigh abduction, flexion and lateral rotation. The muscle is extremely active in running, jumping, throwing, cycling, the tennis serve and in baseball batting.

Gracilis Functions in adduction of the thigh Assist in thigh flexion. Assists in knee flexion if the knee is extended. Assists in medial rotation of the tibia when the knee is flexed.

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Gluteus Maximus Extends and laterally rotates the thigh. The upper fibers of the muscle aid in abduction of the thigh . It functions during walking only with long strides as in running or in jumping. It functions along with the hamstring to decelerate the leg when using a long stride and aids in stabilization of the knee after heel strike.

Hamstrings

When the leg is free to move, they flex the knee and extend the thigh on the pelvis. With the leg fixed, they assist in maintaining erect posture while walking, and aid in the deceleration of the leg at the end of the swing phase of gait. The medial hamstrings aid in medial rotation and the lateral in lateral rotation of the thigh.

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Gluteus Medius This is the primary abductor of the femur. It stabilizes the pelvis on the femur as the weight is being transferred over the foot at mid stance. Assists in medial rotation of the thigh.

Abdominal Oblique The muscle supports the abdominal viscera, aids in rotational support for the pelvis. It aids in the respiratory process through its reflex relaxation during inspiration and its contraction during forced expiration.

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Muscle Testing and Upper Extremity Peripheral Nerve Entrapments pain from the shoulder to the hand and cold hands with symptoms similar to Raynaud’s Abstract: Muscle testing can be used as a phenomenon. The entrapment of the brachial diagnostic key to determine the existence of plexus causes sensory symptoms on the peripheral nerve entrapments. This paper ulnar side of the hand. Travell reports that discusses the basic entrapment syndromes of trigger points in the scalene muscles will the upper extremity and the related findings cause referred pain on the radial aspect of the hand. On inspection, the small muscles using muscle testing. of the hand may appear to have atrophied. Introduction Muscle testing will usually reveal no overt In examining a patient, symptoms in the upper signs of weakness unless the anterior extremity are often confused and improperly scalenes are stressed. The stress is applied related to a spinal causative factor. Especially by varying the position of the patient, following any fall or automobile accident standing, leaning over and fully inspiring the upper extremity must be examined for or having the patient elevate the head while peripheral; entrapment syndromes. The lying supine. Examination of the anterior major entrapment syndromes are presented scalene will uncover an intact muscle that here with their symptomatic picture and has trigger points. These are usually the result of another weak muscle. Frequently muscle testing findings. the latissimus dorsi is found involved. David W. Leaf, D.C.

If weakness is found in the arm with the patient sitting or standing, raising the arm above the shoulder with anterior rotation of Anterior Scalene the shoulder elevates the clavicle reducing Syndrome any neurovascular entrapment. This same position can be used in the following three syndromes to decompress the neurovascular Compression of the brachial plexus, the bundles. subclavian artery and the subclavian vein between the anterior and medial scalene Costoclavicular Syndrome muscles and the first rib can cause symptoms throughout the arm. The muscle fibers, if continually contracted or hypertrophied, This syndrome first affect the lower sections of the brachial refers to entrapplexus. When this becomes chronic, the entire ments of the braplexus, composed of nerve roots from C - 5 chial plexus, the to T - 1 can be affected. Vascular symptoms subclavian artery occur due to the compression of the artery and/or the subclaand/or vein. vian vein as they traverse beneath Symptoms reported by the patient will the clavicle and usually begin with numbness in the hand and fingers radiating up into the forearm, over the first rib.

Discussion

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Symptoms of entrapment are usually transient and brought on by motions of the clavicle or the first rib. The symptomatic pattern is the same as in the anterior scalene syndrome. Muscle testing will reveal no overt weakness patterns until the clavicle or the first rib is stressed. Hand muscles can be tested for weakening. There are two different positions that can elicit a weakness pattern. First, the arm is flexed to 140 degrees and arm or hand muscles are tested. This motion rotates the clavicle involving the subclavius muscle. The shoulder can also be rotated posteriorly with the arm extended to 30 degrees. This shoulder position is similar to the position used in the military. Finally, the patient is asked to fully inspire. This activates the scalene muscles elevating the first rib. If the clavicle has been displaced inferiorly or the first rib is superior a weakness pattern will be created in the arm.

The classical test for entrapment of the axillary artery is the Wright maneuver where the arm is placed in external rotation and the shoulder is abducted. This same position will elicit weakness if the costoclavicular syndrome is present. Muscle testing will reveal no overt weakness patterns in some positions. Creation of the weakness depends upon the contraction or relaxation of the pectoralis minor muscle. If the latissimus dorsi is weak allowing elevation and anterior rotation of the shoulder, the pectoralis minor will be shortened with trigger points in the belly of the muscle. In this case, testing in the standing or sitting posture will reveal weakness of the hand muscles that will immediately strengthen if the arm is elevated above the horizontal with slight flexion of the arm. Care should be taken not to maximally elevate the arm, as that will cause the weakness pattern to return.

Pectoralis Minor Syndrome In this syndrome, neurovascular entrapment of the brachial plexus, the axillary artery and the subclavian vein can occur between the fibers and tendon of the pectoralis minor muscle, the head of the humerus and the coracoid process of the scapula. Symptoms of entrapment are usually transient. The symptomatic pattern is the same as in the anterior scalene syndrome. However, these patients have more vascular symptoms as well as signs of lymphatic blockage. This differs from the scalene involvement where venous blockage is paramount. Commonly, this is found in people who work over their heads or who have excessively developed the pectoral muscles. Symptoms are aggravated by sleeping with the arm elevated or by carrying heavy objects. 72

Suprascapular Nerve Syndrome This is a very commonly overlooked syndrome that can lead to atrophy of the infraspinatus and the supraspinatus muscles. The suprascapular nerve is composed of fibers arising from either the C - 5 or C - 6 nerve roots. It traverses through the suprascapular fossa and the scapular notch to arrive at the supraspinatus fossa. After supplying fibers to the supraspinatus muscle, the acromioclavicular joint and the subacromial bursa, it twists around the base of the spine of the scapula and enters the infraspinatus fossa. Due to this tortuous path, the nerve is stretched as the scapula moves if there is any scapula instability.

Symptoms, reported by patients, will run the gamut from diffuse shoulder pain that is hard to localize to complete atrophy of the infraspinatus first and then the supraspinatus muscles. Symptoms are usually aggravated by any activity that requires extensive motion of the scapula. In most cases, there is no overt weakness pattern. However, if the scapula stabilizers are weak, especially the serratus anterior or rhomboids, the infraspinatus will test weak if tested with the arm flexed to 90 degrees with anterior rotation of the shoulder. This position creates additional torsion on the suprascapular nerve and if the scapula has inadequate support, the infraspinatus will weaken.

Pronator Teres Syndrome This entrapment syndrome is of the median nerve as it passes between the ulnar and radial heads of the pronator teres muscle. After the nerve passes the pronator teres, it divides and supplies the flexor muscles of the wrist and hand except for the flexor carpi ulnaris and the ulnar portion of the flexor digitorum profundus. Symptoms reported by the patient will include loss of strength throughout the hand, difficulty writing, paresthesia throughout the hand and especially the palm. Muscle testing will reveal weakness of the finger flexors that resolves when the radius and the ulna are approximated just distal to the elbow. 73

Supinator Syndrome In this entrapment syndrome the radial nerve becomes compromised as it passes beneath the supinator muscle. Symptoms occur during repeated motions of the forearm. The throwing motion uses all of these. These can include pronation, wrist flexion and forearm extension. The pain pattern is described as deep on the posterior aspect of the forearm. Hand weakness is reported. The easiest muscle to test for this syndrome is the extensor carpi ulnaris. If it is found weak, the head of the radius is approximated to the ulna and the muscle is retested. The extensor carpi ulnaris can also be tested when the supinator is placed in a strain counterstrain position. This position fully relaxes the muscle. Ulnar Sulcus Syndrome The ulnar nerve passes down the posterior surface of the humerus and passes through a sulcus on the medial epicondyle of the humerus. The epicondyloolecranon ligament stabilizes the ulna and the humerus. It also stabilizes the ulnar nerve at the sulcus and prevents it from moving during forearm motions. When the ligament is hypertrophied or stretched, entrapment of the ulnar nerve occurs. The nerve supplies the flexor carpi ulnaris, the ulnar portion of the flexor digi-

torum profundus, the interossei and hypothenar muscles, the adductor pollicis and the deep head of the flexor pollicis brevis. Symptoms include paresthesia and pain over the ulnar nerve distribution and weakness of the above muscles. Testing of the flexor carpi ulnaris with the elbow first in extension and then in flexion may uncover entrapment of the ulnar nerve. If found, the relationship between the humerus and the ulna needs further inspection. Any chronic subluxation, dislocation or avulsion can create ulnar nerve entrapment. After correcting any imbalances, direct attention should be applied to the integrity of the ligament. Flexor Carpi Ulnaris Syndrome As the ulnar nerve leaves the sulcus, it descends between the two heads of the flexor carpi ulnaris muscle. The muscle has a tendinous arch that is formed by the arcuate ligament. This runs from the medial epicondyle to the olecranon. The symptomatic pattern is exactly the same as the syndrome of the ulnar sulcus. This makes differential diagnosis difficult without muscle testing. Accurate testing of the adductor pollicis with the forearm first in a neutral state, then with full contraction of the flexor carpi ulnaris and then with a relaxed approximated (strain counterstrain) position of the flexor carpi ulnaris allows insight into the status of the ulnar nerve as it passes between the heads of the flexor carpi ulnaris muscle. Carpal Tunnel Syndrome This syndrome consists of compression of the 74

median nerve at the fibroosseous canal at the wrist. The tunnel is formed by four major bony prominences, the pisiform, the navicular, the hamate and the trapezium. Between these bony prominences runs the transverse carpal ligament. After this tunnel, the median nerve gives sensory branches to supply the palmar surfaces of the first and second fingers and motor branches to the opponens pollicis, abductor pollicis brevis and the superficial head of the flexor pollicis brevis. Compression of the contents of the tunnel can occur due to edema, local subluxation, fracture, etc. The patient reports symptoms ranging from paresthesia, thenar atrophy and weakness. These symptoms worsen as the condition becomes chronic. As noted above, the median nerve innervates the opponens pollicis muscle. Weakness of this muscle becomes the diagnostic key to isolating the problem. The muscle should be tested with the forearm and wrist in a neutral position, full pronation, full supination, wrist extension and wrist flexion. Ulnar Tunnel Syndrome The ulnar nerve can become compressed at the level of the proximal carpal bones. This tunnel is bordered by the pisiform and the hamate

as well as the transverse carpal ligament and the flexor carpi ulnaris muscle. There are two entrapment syndromes in this area. These correspond to the superficial and deep branches of the ulnar nerves that run through the ulnar tunnel. These nerves supply the sensory distribution to the palmar aspect of the fifth finger and the ulnar side of the fourth finger. The deep branch of the ulnar nerve supplies the interossei muscles the small muscles of the fourth finger and the adductor pollicis muscle. Weakness of either the flexor digiti minimi or the opponens digiti minimi muscles is the key that indicates entrapment of the ulnar nerve at the wrist. Once the weakness is found, directional pressure is applied against the pisiform and the hamate until a vector is found that strengthens the weak muscle. Neurology review A review of the muscular innervation of the upper extremity will aid in reviewing the muscle testing sequence for determining nerve entrapments Radial palsy has been reported after repetitive forceful contractions of the upper arm muscles. Weakness of the deltoid, especially the middle and posterior sections is commonly found in acromioclavicular strains. Severe thoracic outlet syndromes can entrap the superior sections of the brachial plexus creating weaknesses in the deltoids and the teres minor.

The suprascapular nerve supplies the supraspinatus before it bends and winds itself around the spine of the scapula. Instability of the scapula, especially a loss of posterior support can lead to stretching of this nerve and subsequent weakness of the infraspinatus. The axillary nerve supplies the deltoid and the teres minor muscles. Note that before the nerve bifurcates to supply these muscles, branches are given off to the subscapularis, latissimus dorsi and the teres major muscles. Again, these are primary muscles to be used in ascertaining the existence of a peripheral nerve entrapment in the area of the shoulder girdle. As you progress farther down the arm, the pronator teres is the last muscle supplied superior to the elbow by the median nerve. Knowing the status of the pronator teres aids in diagnosing problems arising from entrapment syndromes inferior to the elbow. For example, if the flexor carpi radialis is weak and the pronator teres is strong, then the median nerve is involved at the elbow. When the ulnar nerve is entrapped at the elbow, the flexor carpi ulnaris is the first muscle supplied inferior to the elbow. The integrity of the muscle is important if the flexor digit minimi or opponens digiti minimi is found weak. Weakness of muscles above and below the carpal bones indicates an entrapment syndrome at the elbow and not just at the wrist.

When examining the radial nerve, important There are three muscles innervated by the muscles to test include the supinator, the musculocutaneous nerve in the upper arm. extensor digitorum muscles and the abductor Weaknesses of all three of these muscles, the and/or extensor pollicis muscles. Entrapment coracobrachialis, biceps and the brachialis syndromes as the radial nerve passes downs the forearm will create weakness patterns may indicate a thoracic outlet syndrome. relative to the level of the first muscle found Notice that the ulnar nerve does not supply weak. Generally, all of these muscles will be any muscles until it is well down the humerus weak if the radial nerve is entrapped. On the posterior aspect of the shoulder, the major missed entrapment syndromes involve inadequate stabilization of the scapula. 75

In the hand, weakness patterns of the opponens pollicis, with a finding of strength in the muscles innervated superior to the wrist

by the median nerve, indicates the probable presence of a carpal tunnel syndrome. A common testing procedure will find the flexor digitorum superficialis and profundus strong and the opponens pollicis weak. If all three muscles are found weak, the entrapment syndrome is at the elbow or mid forearm Testing of the ulnar nerve at the wrist consists of testing for the relative strength of the opponens digiti minimi or the flexor digiti minimi in comparison with the strength of the flexor carpi ulnaris. If the flexor carpi ulnaris is weak along with the muscles of the fourth finger, then the ulnar nerve is entrapped at the level of the elbow or above. Weakness of the finger muscles in the presence of strength of the flexor carpi ulnaris indicates a problem of entrapment at the level of the carpal bones. Note the innervation of the adductor pollicis. Improper testing of the opponens pollicis will result in recruitment of the adductor pollicis and erroneous findings. Conclusions Muscle testing is an art as well as a science. One of the best uses of muscle testing is in aiding your examination procedures. Reproducible results depend on consistent testing. This testing must not only be reproducible from one examination of another, but must also be done accurately. A common error is improper testing of the opponens pollicis muscle. If this test is properly performed, you are testing median nerve function. If the test is done improperly, you could be testing the ulnar nerve or a combination test that would challenge the integrity of the median as well and the ulnar nerve. References Cravens, G.; Kline, D., Posterior interosseous nerve palsies, neurosurgery, Vol27, No. 3 (Sep. 1990) Gray, Henry; Goss, Charles, Anatomy of the Human Body, Philadelphia, PA, Lea & Frebiger 1966 Kendall, Florence; McCreary, Elizabeth, 76

MUSCLES Testing and Function, Baltimore, MD Williams and Wilkins 1983 Streib, E. Upper arm radial nerve palsy after muscular effort: report of three cases, Neurology. Vol 42 No 8 Aug. 1992 Travell, Janet; Simons, David, Myofascial Pain and Dysfunction The trigger point Manual, Baltimore, MD., Williams and Wilkins, 1983 Walther, David, Applied Kinesiology – Synopsis, Pueblo, CO., Systems DC, 1981

Cranial Motion By David Walther, D.C., DIBAK Excerpted from Synopsis – Systems DC Pueblo CO 1988

The plastic nature of bone in vivo is illustrated in a study by Stowe et al. 2 Orthogonal x-ray beams were used to measure the absolute and One who works with the cranial-sacral relative movements and consequent torsion of primary respiratory mechanism is often the adult human forearm in vivo during its confronted with the question, “Do the bones of rotation from maximum voluntary supination the skull really move?” Although the question to maximum voluntary pronation. A torsion becomes an irritant to those knowledgeable of 69° was observed in the ends of the radius; about cranial function, it is a reasonable 34° was seen between the ends of the ulna. one to ask since most persons trained in the healing arts are taught that the primary The histology of a suture is that of a joint purpose of the skull is to protect the brain and designed for motion. Pritchard et al. 3 found provide a place to hang the face. In addition, five distinct layers of cells and fibers between students are exposed to the skull as a dried the edges of the adjoining bones in human osteologic specimen, or in a cadaver wherein specimens. They concluded that”. . . histology little study is usually made of the skull and of the sutures suggests that it has two main its mechanisms. functions, viz. that it is a site of active bone growth and that it is at the same time a firm This writer has spent hundreds of hours bond of union between the neighboring bones, studying the disarticulated bones of the skull which nevertheless allows a little movement.” for initial education, and hundreds more The first of five layers making up the suture while doing photography for a textbook.1 I is bone. The cambial layer is the growth cannot understand how anyone can study the center that thins as growth ceases, and the pivot points, angles of articulation, lines from capsular layer is light cartilage that provides bones sliding on each other, and gear-train protection. The middle aspect in the suture mechanisms of a disarticulated skull and not is a vascular layer similar to the synovial conclude that it is designed for motion. The joint cavity. Finally, covering the suture is ossification of sutures that occurs in some the uniting layer that is the homologue of the skulls in later life is a pathologic process, not fibrous capsule. a natural one. Upledger et al. 4 studied specimens taken from In addition to the joints of the skull, one must living adult skulls at the time of neurosurgical recognize the flexibility of living bone. What craniotomies. Along with connective tissue, is not considered in most doctors’ education the sutures were shown to have the presence is that the skull in vivo is a dynamic, plastic of viable myelinated and unmyelinated nerve structure that has additional organized fibers and nerve receptor endings.5, 6 One activity. Studying the skull from a dried method of examining the cranium for faults is specimen or in a cadaver is similar to studying for the applied kinesiologist to apply pressure a telephone pole as if it were a living tree. to various portions of the skull and observe The telephone pole is rigid, the sap is dried, for a manual muscle test change. It appears there is no living flow, and an effort to bend that stimulation of the neurostructures in the it could cause it to break. A living tree, on the suture is responsible for some of the remote other hand, has water and nutrients in its muscle changes observed. Motion of the skull “veins.” It bends and sways with the breeze bones has been objectively measured. The and progresses through its life cycle from year first study was made by Frymann.7 When to year. she applied transducers to a subject’s head, 77

condition has been present for a considerable time the teeth may have changed position by the natural process of remodelling, thus locking in the cranial faults. In this case it Further motion studies have been done to may be necessary to consult a dentist for a bite eliminate effects of intervening tissue between plane, and perhaps eventual equilibration of the transducer probe and the skull. Michael the teeth. and Retzlaff 9 attached force transducers to a screw eye placed in the parietal bone of The pelvis and sacrum are intricately involved anesthetized monkeys. A cyclic cranial bone in the cranial primary respiratory mechanism, displacement of 5-7 cycles per minute was and may require chiropractic correction to observed that could not be attributed to either eliminate temporomandibular joint or occlusal respiration or heart rate. problems. A short leg has been indicted as a cause of malocclusion. Strachan and Robinson, The position of cranial bones in relation to 13 of the Chicago College of Osteopathy, were each other can be observed on accurately the first to observe a short leg’s influence positioned x-rays. 10 Cranial nerve V angles on malocclusion. Evaluating the pattern of over the petrous apex of the temporal bone. masticatory muscles with electromyography, Gardner 11 measured the height of the petrous they removed a 3/8” heel lift from a standing apex by x-ray and found that trigeminal subject’s shoe and found an altered firing neuralgia occurred three times more often on sequence of the muscles of mastication during the side of the high petrous apex than on the chewing. When the lift was worn, the muscles showed the firing pattern of normal occlusion; low side. with it removed, the firing pattern was one of Cranial distortion may change the dental a severe malocclusion. In applied kinesiology, occlusion by mandibular movement change an apparent short leg is quite often found to or by disrelation of the cranial bones. be a result of pelvic distortion. The leg usually Malocclusion is a common complaint following balances with pelvic correction. In any event, an auto accident with whiplash dynamics their study reveals the importance of remote to the neck and head. Many doctors fail to postural imbalance on the stomatognathic appreciate this because the patient often does system. not discuss it with the orthopedically-inclined physician. If the patient discusses the matter The stomatognathic system is very active with a dentist who is not knowledgeable about in the dynamic motions of the body. During cranial motion, the teeth may be equilibrated walking the sternocleidomastoid and upper to match the distorted skull; this locks in the trapezius muscles are alternately inhibited cranial faults and makes correction difficult or and facilitated, providing a rhythmic pull on impossible without further dental attention. cranial bones. Because of the stomatognathic Baker 12 found a 0.0276” increase in the system’s muscle interaction with the rest of distance between the second molars following the body, improper gait and other dysfunction may be the perpetuating cause of recurrent cranial manipulation. cranial faults. It is important to understand all of the aspects that can be involved in dysfunction of the stomatognathic system. A patient may come Integration of the Stomatognathic System to a chiropractor for a whiplash-type injury to the cervical spine. This condition often relates with cranial faults that may in turn cause With normal function there is predictable malocclusion. Correcting the cranial faults movement of the cranial bones. It continues may correct the malocclusion; however, if the throughout life, cycling 10-14 times per

she found a rhythmic autonomous motion supporting Sutherland’s 8 original observation of 10-14 cycles per minute.

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minute, and is called “the primary respiratory mechanism.”8 The motion is separate from the heart or breathing rate; however, cranial motion is enhanced by thoracic respiration. Although this influence is always present, relaxed breathing and primary respiration do not always parallel.

of the frontal bone move medially. In applied kinesiology this is called external frontal rotation, as if the metopic suture area were moving externally. This is confusing, because an external frontal in DeJarnette’s sacro occipital technique 14, 15 is called an internal frontal in applied kinesiology, and vice versa.

Cranial motion is a combination of bending bone and suture motion. The motion between the sphenoid and the occiput is in the sagittal plane. There is a flexion and extension of the sphenobasilar junction. Prior to the approximate age of twenty-five, the motion is at the synchondrosis between the bones. After ossification, the motion is flexion and extension of the cancellous bone. Sphenobasilar flexion consists of raising the sphenobasilar junction and separating the superior portions of the occipital squama and greater wings of the sphenoid. Sphenobasilar extension is dropping of the sphenobasilar junction and approximation of the superior portion of the occipital squama and greater wings of the sphenoid. Sphenobasilar flexion is enhanced by a deep phase of inspiration; extension is enhanced by expiration. Often sphenobasilar movement is called sphenobasilar inspiration or expiration.

The rest of the bones of the skull and face have specific movement in relation to sphenobasilar flexion and extension. There is continuity in the movement by way of pivot points, gear trains, sliding action, and lever mechanisms; this interaction constitutes a closed kinematic chain. In any closed kinematic chain, when one portion moves the entire chain must move. This can be demonstrated by a system of levers or gears, both of which are present in the cranial closed kinematic chain. The occipitomastoid suture acts like teeth on a gear. The vomer is a lever mechanism between the rostrum of the sphenoid and the intermaxillary and palatine sutures of the maxillary and palatine bones.

The general axis of temporal bone rotation is through the petrous portion, which is at approximately a 60° angle with the temporal bone’s squamous. The apex of the petrous portion rises on inspiration with the sphenobasilar junction, and the petrous ridge rotates anterolaterally, causing the squamous of the temporal bone to rotate externally. The mastoid process moves posteriorly and medially with inspiration. The frontal bone, in most subjects, ossifies at the metopic suture. In some cases a remnant or the entire suture persists throughout life. Motion on sphenobasilar flexion (inspiration) spreads the frontal bone’s squamous portion. In applied kinesiology this is called internal frontal motion, as if the metopic suture were moving internally. On sphenobasilar extension (expiration), the squamous portions 79

There is a synchronous movement between the sphenobasilar junction and the sacrum. The connection is the dura mater, which has a firm attachment at the foramen magnum and 2nd and 3rd cervical vertebrae. Attachment along the rest of the spinal column is loose, until the dura and arachnoid firmly attach at the 2nd sacral segment. The general axis of sacral rotation is at the level of the 2nd sacral segment about its transverse axis. Motion of the sacrum consists of lifting the anterior portion of the 2nd sacral segment as the sphenobasilar junction lifts in inspiration; thus, the apex of the sacrum moves anteriorly and the base posteriorly with inspiration, and opposite with expiration. The innominate bones also have a primary movement organized with cranial function. If one compares the innominate with the temporal bone, the comparative parts move in the same direction with inspiration and expiration. The ilium is compared with the squama of the temporal bone; it moves anterolaterally with inspiration. The ischium, compared with

the mastoid process, moves posteromedially. Pressure from the abdominal contents and the abdominal muscles contributes to this motion. On inspiration the abdominal contents move downward, putting pressure on the ilium to move the anterior iliac spine laterally, anteriorly, and inferiorly. Simultaneously with inspiration, the abdominal muscles relax to permit this motion. During expiration, the abdominal muscles contract, reversing the motion of the ilia. Organization between the closed kinematic chain of the cranium, with its movement of the pelvis by the dura mater and abdominal muscle contribution, emphasizes how integrated the motion of the stomatognathic system is with the rest of the body. Within the stomatognathic system as Shore 16 defines it - from the shoulder girdle up - there is further integration and another closed kinematic chain. This is a muscular closed kinematic chain made up of the cervical flexors and extensors, hyoid muscles, and muscles of mastication. The original presentation of the muscular closed kinematic chain of the stomatognathic system was described in a program of the University of Illinois 17 in 1949. Mintz 18 discusses the interaction of this closed kinematic chain and its correlation with the rest of the body. Disturbance here can cause a chain reaction throughout the musculoskeletal system. On the other hand, remote musculoskeletal imbalance or dysfunction can disrupt the harmony within the stomatognathic closed kinematic chain. In an article directed toward the legal profession, Moses and Skoog 19 draw attention to the similarity of symptoms between cervical whiplash and temporomandibular joint conditions, indicating that either may be caused by an auto accident. Recognizing the interplay within the stomatognathic system, it is entirely reasonable that there are similar symptoms. Often when the cervical spine is injured, the temporomandibular joint ultimately becomes involved; if the jaw is injured, affecting TMJ dysfunction, 80

the cervical spine may ultimately become involved. They also point out the potential hazard of the conventional treatment of cervical bracing and traction on the TMJ, which is not designed to be a pressure-bearing joint. 20 1 Walther, D.S., Applied Kinesiology, Volume II - Head, Neck, and Jaw Pain and Dysfunction - The Stomatognathic System (Pueblo, CO: Systems DC, 2 Stowe, R.S., L.L. Lavoy, & N.A Frigerio, “Measurement of bone torsion in vivo via biostereoroentgenography,” XIII lnt Congress Photogrammetry (JuI11-13, 1978). 3 Pritchard, J.J., J.H Scott, & F.G. Girgis, “The structure and development of cranial and facial sutures,” J Anat, Vol 90 (Jan 1956). 4 Upledger, J.E., E.W. Retzlaff, & J.D. Vredevoogd, “Diagnosis and treatment of temporoparietal suture head pain,” Osteo Med (JuI1978). 5 Retzlaff, E.W. et aI., “Nerve fibers and endings in cranial sutures,” JAOA, Vol 77 (Feb 1978). 6 Retzlaff, E.W. et aI., “Temporalis muscle action in parietotemporal suture compression,” JAOA, Vol 78 (Oct 1978). 7 Fryman, V.M., “A study of the rhythmic motions of the living cranium,” JAOA, Vol 70 No 9 (May 1971) 8 Sutherland, W.G., The Cranial Bowl (Mankato, MN: privately published, 1939). 9 Michael, D.K., & E.W. Retzlaff, “A preliminary study of cranial bone movement in the squirrel monkey,” JAOA, Vol 75 (May 1975). 10 Greenman, P.E., Roentgen findings in craniosacral mechanism,” JAOA, Vol 70 No 1 (Sep 1970) 11 Gardner, W.J., “Trigeminal neuralgia,” Clin Neurology, Vol 15 (1967) 12 Baker, E. G., “Alterations in widge of maxillary arch and its relation to sutural movement in cranial bones.” JAOA, vol 70, no 6 (Feb 1971) Reprinted in Dental Orthopedics, ed H.E. Ravins (Beverly Hills, CA: Preventative Dental Res, 1981) 13 Strachan, W.F., & M.J. Robinson, “New

osteopathic research ties leg disparity to malocclusion,” Osteo News, Vol 6, No 2 (Ape 1965). 14 DeJarnette, M. B., Cranial Technique 1968 (Nebraska City, NE:privately published, 1968) 15 DeJarnette, M. B., Cranial Technique 1979 – 1980 (Nebraska City, NE:privately published, 1979) 16 Shore, N.A, Temporomandibular Joint Dysfunction and Occlusal Equilibration, 2nd ed (Philadelphia: J.B. Lippincott Co, 1976). 17 Current Advances in Dentistry, Telephone Extension Program, Univ. of Illinois College of Dentistry (1949). 18 Mintz, V.W., “The orthopedic influence,” in Diseases of the Temporomandibular Apparatus - A Multidisciplinary Approach, ed D.H. Morgan et al. (St. Louis: The C.V. Mosby Co, 1982). 19 Moses, AJ., & G.S. Skoog, “Cervical whiplash and TMJ - similarities in symptoms,” Trial (Mar 1986). 20 Robinson, M., “The temporomandibular joint: Theory of reflex controlled nonlever action of the mandible,” JADA, Vol 33 (Oct 1, 1946).

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Respiratory Challenge Strong muscle weakens on a specific phase of respiration indicates the following cranial fault on the side of the skull that the muscle was tested on.

Maximal Inspiration

Sphenobasilar Expiration

Normal Inspiration

Expiration Assist

1/2 Inspiration

Parietal Descent

1/2 Expiration

Temporal Bulge

Normal Expiration

Inspiration Assist

Maximal Expiration

Sphenobasilar Inspiration

Weak muscle strengthens on the following phase of respiration indicates the following cranial fault

82

Maximal Inspiration

Sphenobasilar Inspiration

Normal Inspiration

Inspiration Assist

1/2 Inspiration

Temporal Bulge

1/2 Expiration

Parietal Descent

Normal Expiration

Expiration Assist

Maximal Expiration

Sphenobasilar Expiration

A Brief Discussion of the Neurology of Cranial Manipulation Richard Belli, D.C., D.A.C.N.B. For years clinicians have observed marvelous results from cranial bone manipulation, but along with these observations have come a great deal of conjecture and debate as to the mechanism. This discussion covers some of the plausible neurological mechanisms for these observations. These mechanisms include tonic labyrinthine reflexes, dural innervation, postural modulation by vestibulospinal projections, and vestibular projections to the reticular formation, thalamus, and hypothalamus. The most striking observation of cranial manipulation is the diversity of physiological and therapeutic response. For decades clinicians have observed resolution of everything from low back pain to tachycardia. These observations, because they are so diverse have given cranial manipulation an almost mystical connotation, how else could such diverse responses be explained?

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The debate has raged among anatomist and clinicians as to whether cranial bones do in fact move or if the sutures are fused making the cranium an immovable vault. It has been well documented by Upledger that there is a cranial respiratory mechanism. Many anatomist and clinicians claim that the cranium in vivo is wet and flexible, thus allowing for movement. This all leaves us with a preponderance of evidence that the cranium in vivo is an alive and movable mechanism. The aforementioned leads us to the discussion as to what mechanically happens when the cranium is manipulated. Keeping it simple, and without getting into specific techniques, we assume that cranial techniques generally restore normal juxtaposition relationships and movement to the cranial respiratory mechanism. By restoring normal motion and function, one would assume that there is a change in the dura, or better said in dural tension, as well as a normalization of the bilateral temporal bone relationship. As discussed by Walther, Upledger, and others,

the cranium is believed to function as a closed kinematic chain, in other words you can not affect a bone as a single entity, manipulation of one bone will affect all of them. The dura is supratentorially innervated by the trigeminal nerve and infratentorially by the vagus nerve. This makes it enticing for cranial practitioners believe that cranial manipulation may have it therapeutic responses via the afferents of these nerves. Another school of practitioners finds it irresistible to believe that changes in cranial motion and normalizing of the flow of cerebrospinal fluids leads to therapeutic changes. And finally, some practitioners believe that normalization of the temporal bone relationship to each other accounts for the therapeutic effect. Lets now look at these suspected mechanisms and determine which can explain the spectrum of clinical change. Logic would tell us that the modality that encompasses the neurological pathways that explain the broad spectrum of clinical change would be our prime candidate. Looking at the dura we have to take into consideration the sensory innervation and such aspects as dural tension. As previously mentioned the dura is innervated supratentorially by the trigeminal nerve and infratentorially by the vagus nerve. When the vagus and trigeminal nerves are brought to threshold by some sort of mechanical pressure the axons project to the sensory nuclei of each one of these nerves These include the sensory nucleus for the trigeminal nerve and the solitary nucleus for the vagus nerve. In theory the vagal and trigeminal afferent input will facilitate via collaterals the motor nuclei for the reticular formation and other bulbar nuclei facilitating visceral and somatic efferents. This in theory can account for visceral changes seen with cranial manipulation. The question at hand is whether the amount of movement that the cranial manipulation imparts is enough to bring the sensory aspects of the dura to threshold? Also we must consider that the

majority of these afferents are nociceptive has are not restricted to blood pressure in nature. As Upledger describes there ischanges. a The reticulospinal pathways great deal of movement in the cranial sacral drive the intermediolateral cell column and respiratory mechanism. If this movement subsequently is the autonomic system. The not enough to bring these afferents to threshold reticular formation involvement alone can it is not likely that cranial manipulation will. account for visceral as well as somatic changes. However, this constant motion of the cranial There are abundant vestibular projections to sacral mechanism may be enough to maintain the cerebellum. The cerebellum has projections a base line level of mechanoreceptor barrage to the reticular formation, and directly and from the dura. If this is the case, then indirectly in to the thalamus. These projections theory, if there is a change in cranial sacral can account for autonomic changes via the motion then the afferent barrage from the thalamohypothalamo pathways, and cortical dura to the sensory nuclei of the trigeminal changes from projections from the thalamus nerve and the solitary nucleus of the vagus to the cortex. Also, the cerebellum modulates nerve would change. In other words, movement a via cerebellobasalganglionic and normal amount of cranial sacral motion will cerebellothalamocortical projections. And maintain a normal amount of afferent input finally, the reticulospinal and vestibulospinal to vital centers. Looking at cerebral spinal pathways modulate trunk flexion and fluid flow as a candidate one must question extension. Additionally, the vestibular the actual changes that take place in pressure mechanism projects directly to the thalamus from normal abdominal and thoracic cavity and hypothalamus. The thalamic projections pressure changes. The CSF pressure ranges are thought to account for cortical appreciation from 50 to 150 mm Hg. Keeping this in mind of position changes. And the hypothalamic it is not likely that the subtle changes that projections are thought to be necessary for are made with cranial manipulation are going autonomic response to movement. After to have a significant effect on the overall examining the three possible mechanism for pressures. the effect of cranial manipulation it is easy to see that the vestibular apparatus has The vestibular system is of primary the largest potential for affecting change on importance in maintaining upright posture, the central neuraxis and consequently the muscle tone and eye movement. The two overall physiology. However I also find it vestibular apparati do not function properly difficult to completely ignore the possibilities unless they are in normal juxtaposition with of dural feedback from the mechanoreceptors each other. If their positional relationship located is there. So the conclusion that I would lost, the vestibular output is of two different draw, with the available information, is that messages, which makes accurate central the vestibular mechanism is the primary processing impossible. The central pathways mechanism with the dural mechanoreceptor of the vestibular system are principally motor mechanism secondary. reflex connections to nuclei innervating extraocular muscles, the motor reticular If one takes into account the vast neuronal formation, the spinal motor neurons, and the network affected by the vestibular mechanism cerebellum. With this in mind one can see it is easy to account for the far reaching there is an enormous amount of potential effects that cranial manipulation can have on for affecting physiological function. The the health of the patient. If the practitioner vestibular projections to the motor reticular has these pathways to memory and available formation are multipurpose in nature. When for explanation it will be effortless for him you consider that blood pressure needs to to explain to other practitioners why he change with position and muscle tone needs is getting such fabulous results from his to change with position it is easy to see the treating techniques. This should be another necessity of these projections. Additionally, the example as to why we need to have a greater autonomic effect that the reticular formation understanding of what we are accomplishing 84 when we are using manipulative therapies.

Cranial Nerve Examination

Olfactory Type Sensory Function Smell Cranial Fault Frontal- ethmoid Exits Cribiform plate Olfactory Sensory cells end in upper posterior portion of the nasal cavity Passes through the cribiform plate Dura mater covers the tract

Optic Type Sensory Function Vision Cranial Faults Sphenoid Exits Optic foramen Optic Three coverings Outer from the dura mater Middle from the arachnoid mater Inner from the pia mater Nerve lies in a canal of the lesser wing of the sphenoid

Oculomotor 3, Trochlear 4, Abducens 6

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Type Motor Function

Eye motion Vertical oculomotor Down and in motion -Trochlear Lateral Cranial Faults Frontal, sphenoid, ethmoid, temporal Exits Supra Orbital fissure

Oculomotor Passes between the attached and free borders of the tentorium cerebelli Trochlear Supplies the superior oblique muscle Follows along free border of the tentorium cerebelli Abducens Supplies the lateral rectus muscles Passes lateral to the dorsum sellae of the sphenoid bone Traverses the superior portion of the petrous portion of the temporal bone Eye motions Lateral Lateral rectus VI Medial Medial rectus III Medial & superior Superior rectus III Medial & inferior Inferior rectus III Lateral & superior Superior oblique IV Lateral & inferior Inferior oblique III

Trigeminal V Function Opthalmic - Sensory Nose, forehead, scalp Maxillary - Sensory Cheek, nose, upper lip Mandibular - Mixed

Mandible, lower lip, Muscle of mastication Jaw reflex Cranial Faults Frontal, sphenoid, ethmoid Exits Motor - Foramen ovale

Opthalmic Maxillary Mandibular

Sensory - Superior orbital fissure

Trigeminal

Semilunar ganglion lies in a recess of the dura mater near the apex of the petrous portion of the temporal bone

Opthalmic Nerve Branches enter by superior orbital fissure Lacrimal Lacrimal gland Frontal Supratrochlear - conjuctiva, medial upper lid, lower & middle forehead Supraorbital upper eyelid, scalp, frontal sinus Nasociliary External nasal skin of apex and vestible of the nose Infratrochlear skin of side of nose & eyelids Ethmoid ethmoid & sphenoidal sinuses Internal nasal Maxillary Nerve Branches Exits through foramen rotundum Cranial - dura of the middle cranial fossa Pterygopalatine fossa branches 86



Zygomatic Zygomaticotemporal skin side of forehead Zygomaticofacial skin over zygomatic arch Greater Palatine hard palate and gums Infraorbital canal alveolar socket and non-molar teeth - floor of nasal cavity Fascial lower eyelid, side of nose, upper lip mouth mucous membranes Mandibular Nerve Branches Exits through foramen ovale Ramus meningeus dura - mastoid air cell mucous membrane Reenters skull through the foramen spinosum Medial Pterygoid internal pterygoid, tensor veli palatini, tensor tympani Mandibular Nerve Branches Exits through foramen ovale Anterior division muscles of mastication skin and mucous membranes of the cheek Masseteric - masseter Deep temporal - temporalis Lateral pterygoid - lateral pterygoid Buccal skin of cheek, mouth mucous membranes, gums

Facial Type Mixed Function Taste anterior tongue Facial expressions Cranial Faults Temporal bone

Cranial faults Temporal/occipital Exits Jugular foramen

Exits Stylomastoid foramen Supplies Buccinator, platysma, stylohoid and posterior belly of the digastric Lacrimal and salivary glands Membranes of the palate, nasal pharynx and nasal cavity

Spinal Accessory

Vestibulocochlear Type Sensory Function Hearing / equilibrium Cranial Fault Temporal bone Exit Temporal bone



Type

Mixed Function Taste posterior tongue Muscles of swallowing Cranial Faults Temporal/occipital Exit Jugular foramen

Vagus Function Sensory Visceral organs, esophagus Muscles - Larynx. Pharynx Palate reflex Autonomic Control gastric motility, Blood pressure, respiration, Heart rate 87

Function Trapezius / SCM Cranial Faults Temporal/occipital Exit Jugular foramen



Hypoglossal Type Motor

Glossopharyngeal IX

Type Motor

Function Tongue

Cranial Faults Occitput - occiput/atlas

Cranial nerve function can be evaluated in a more objective manner using muscle testing. The procedure is to first determine a normal testing muscle that you will use for the testing. The muscle will be tested for inhibition while the cranial nerve is either stimulated or caused to increase its function. Usual findings will be a combination of positive tests that are related to the location where the cranial nerves exit the skull. The cranial nerves can be divided into four groups. The first is olfaction that is an extension of the brain. Imbalances in the bones between the frontals may be found. The next group of cranial nerves, II - VI, is adversely affected by imbalances in the sphenoid and the frontal bones. The next group, VII and VIII, is related with temporal bone problems. The final group, IX - XII, is related to imbalances of the occiput. A common finding is to have positive findings on one side of the skull. If this is the case, have the patient place himself or herself in a gait position, one leg forward and the opposite shoulder rotated anterior, and retest for changes in the positive findings. If this position changes the inhibition pattern, it indicates the effects of dural torque. Dural torque refers to mechanical problems where the dura mater attaches firmly. These can include coccyx, sacral, upper cervical or cranial problems like sphenobasilar and TMJ imbalances. Testing needs to be done to determine the location of the mechanical fault and proper correction given. It is not uncommon to find dramatic changes in functioning of the cranial nerves after proper correction of the cranial and spinal faults.

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Oral Nutrient Testing us represent three cranial nerve ganglia (CN VII, IX and X). These axons carrying taste information extend via the rostral/gustatory In 1968, Goodheart introduced testing nutri- portion of the nucleus solitarius to the ventional substances by monitoring muscle test- tral posteromedial nucleus (VPM) of thalaing responses associated with gustatory stim- mus. The third order neuron in the pathway ulation by nutritional substances. ascends to the ventral lateral portion of the postcentral gyrus, areas 3, 1, and 2. This Placing substances on the tongue, such as nu- pathway, the Solitariothalamic tract remains trients in which the patient is lacking, were ipsilateral. associated with a conditional facilitation of otherwise inhibited muscles. by Jayson Grossman, D.C.

Placing offensive substances on the tongue, such as toxic substances, overdosed medications, and food allergens, were found to be associated with a conditional inhibition of otherwise facilitated muscles. Neurophysiological Rationale Taste receptors are found within taste buds located not only on the tongue but also on the soft palate, pharynx, larynx, epiglottis, uvula and first one third of the esophagus. Taste buds are continually bathed in saliva, and excessive dryness can distort taste perception. This effect is commonly observed, for example, with gustatory receptor stimulation using syrup of ipecac, which induces an immediate and violent motor response, which induces the patient to vomit.

It is thought that there are projections from the primary somatosensory region in the postcentral gyrus (parietal lobe) to the primary motor cortex located within the precentral gyrus of the frontal lobe. These projections essentially modulate the central integrative cortical state thereby culminating in a net inhibition or facilitation of the motor axon pool.

Afferents from the taste bud receptors of cranial nerves VII, IX, and X synapse in the nucleus of the tractus solitarius with ongoing projections to the thalamus, hypothalamus and cortex. The information is then sent via the descending efferent motor pathways and is demonChanges in muscle testing outcomes following strated by the strengthening of a previously taste bud receptor stimulation is hypothesized weak muscle (facilitation) or the weakening of to be associated with changes in the central a previously strong muscle (inhibition). integrative state (CIS) in the hypothalamus, cortex, or both. Clinical Rational The axons within the rostral tractus solitari89

Oral nutrient testing is widely used by Applied Kinesiology practitioners to aid the cli-

nician in making the best choice of nutritional substances, medications, herbs, and other substances when there are numerous possibilities from which to choose. It is also widely employed as a screening test to identify which laboratory evaluation may be best suited to a patient. For example, a patient who shows a strengthening response to insalivation of an anti-histamine would be considered a candidate for allergy testing, regardless of what symptoms are displayed.

In this manner, the clinician may efficiently identify dysfunctional physiological processes at the root of patients’ symptoms, rather than merely give the symptoms a named diagnosis. A single blinded, uncontrolled pilot study of AK and allergy testing was performed by Schmitt and Leisman (1998). In this study, 19 of 21 foods associated with muscle weakness on oral challenge showed a subsequent elevation of serum IgE, IgG, and/or IgG immune complexes.

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A Pilot Study Showing Efficacy For Applied Kinesiology Muscle Testing Procedures as a Screening Tool For Immune System Mediated Food Allergy Patterns FIGURE 1 4 types of hypersesitivity response (Gell - Coombs) Abstract: Seventeen patients were found ANTIBODY MEDIATED IMMUNITY positive on applied kinesiology (A.K.) muscle TYPE I - IgE - ANAPHYLACTIC TYPE testing screening procedures indicating food TYPE II - IgG (and IgM) - CYTOTOXIC hypersensitivity (allergy) reactions. Each RESPONSE patient showed muscle weakening (inhibition) TYPE III - IMMUNE COMPLEXES reactions to oral provocative testing of one CELL MEDIATED IMMUNITY or two foods for a total of 21 positive food (T CELLS AND MACROPHAGES) reactions. IgE (RAST), IgG (RAST), IgE TYPE IV -DELAYED immune complex, and IgG immune complex HYPERSENSITIVITY assays were performed for all 21 of the A.K. positive testing foods. 19 of the 21 foods (90.5%) positive for hypersensitivity response IgG (or IgE) combines with antigen to form on muscle testing showed one or more positive an antigenantibody complex. One antigen can bind at least two IgG molecules together. blood tests. This sets up the potential for chains of these antigen-antibody molecules which are called INTRODUCTION The four classic hypersensitivity reactions immune complexes. IgG is converted to IgG which describe allergic reactions to foods, immune complex which should be cleared airbornes, and other antigens are called the by the liver and/or the spleen. When these Gell-Coombs Types I, II, III, and IV reactions. immune complexes build up, this is the basis 1 (See Figure 1.) In hypersensitivity reactions for Type III reactions. of the Gell-Coombs types I and II, higher than normal amounts of IgE (type I) or IgG The rate of formation and clearing of IgG (type II) are produced by plasma cells when immune complexes affects both the levels of they encounter antigens. (IgM or IgA can also IgG and its immune complex. In other words, be produced in a type II reaction.) Immune IgG may be rapidly produced, but just as complexes which are produced and are not rapidly converted to immune complex form. adequately broken down (by the liver and/ This can result in low IgG while IgG immune or the spleen) will be elevated in type III complexes may be severely elevated. Likewise, reactions. A typical type IV reaction is the IgG may be elevated while IgG immune tuberculin skin test. Type IV reactions will complexes may be adequately cleared. This explains the necessity of measuring as many not be discussed further in this paper. parameters as possible before ruling out immune hypersensitivity reactions. by Walter H. Schmitt, Jr., D.C

The type I reactions result in rapid (anaphylactoid) type reactions. Histamine release by mast cells is the major symptom producing factor. The half-life of IgE is 2 1/2 days. The type II IgG type reaction is complement mediated and results in a slower onset of symptoms (a type of delayed 91

hypersensitivity). IgG has a half-life of 21 Lebowitz 3 and this author. 4 These included 1) days, hence its effects are much longer lasting a weak muscle strengthening on insalivation of the natural anti-histamine, yakriton, 2) than an IgE reaction. a strengthening response on insalivation of Immune complex formation is potentially the copper, 3) a positive therapy localization (T.L. most tissue destructive as these complexes - causing a weak muscle to strengthen) to the settle in tissues and cause microthrombi thymus area over the angle of Louis on the formation, complement cascade which can sternum, 4) a positive T.L. to thymus with result in tissue damage, and leukocyte copper in the mouth, and/or 5) a strong muscle chemotaxis with the subsequent release of weakening during simultaneous T.L. to the inflammatory mediators. Immune complexes thymus while a copper antagonist supplement have been implicated in autoimmune disease (Cop Out) is in the mouth. These screening processes. Applied kinesiology procedures tests are listed in Table 1 under “pre-test involve muscle testing as a functional findings”. Patients who were positive on one evaluation of patterns of inhibition and or more of these tests were further tested for muscle testing reactions to common food facilitation in the nervous system. allergens. These included whole wheat flour, Many clinical factors have been found to cornmeal, soy flour, brewer’s yeast, baker’s effect neuromuscular function and result yeast, cow’s milk powder, powdered , egg, in patterns of inhibition which induces potato flour, and others. reversible weakness of muscles to standard testing procedures. One factor which is said to While the food was held in the patient’s affect changes in muscle strength is the oral mouth, various strong muscles were tested to insalivation of allergic foods. A.K. procedures observe for changes in strength. A weakening involve a particular type of provocative testing of strong muscles to oral challenge with a food for food hypersensitivity which is based on the is an A.K. finding suggestive of food sensitivity patient insalivating a food substance and the to that food. With the weakening food in the doctor performing muscle testing to various patients mouth, several additional factors were tested to identify possible negation of muscles. the weakening response. A weakening reaction of the muscle induced by the patient’s insalivation of the food is These factors were 1) placing yakriton in the suggested to be indicative of a neuromuscular mouth (with the food), 2) T.L. to the thymus hypersensitivity (allergic) reaction to that area, 3) T.L. to the liver neurolymphatic reflex food. Although this type of provocative (NL), and 4) placing the spine . in a right foot testing procedure to identify food allergies or gait torque pattern (called a CCW torque) by hypersensitivities is widely employed by A.K. placing orthopedic wedges under the right hip doctors, only one study has been performed and the left shoulder. If a patient was negative to test this hypothesis. 2 This project was to the CCW torque of the spine, other spinal designed as a pilot study to identify if, in positions were checked for negating the food fact, the reported weakness on provocative induced muscle weakness. oral neuromuscular hypersensitivity to foods is due to food allergy or hypersensitivity as One patient (#14) was found to have the identified by measurements of standard weakness negated by a left convex lateral flexion of the spine. These findings are listed immune system blood assays. in Table 1 under “with food in mouth”. When a weakening response to oral food challenge MATERIALS AND METHODS is observed, blood was drawn prior to further Patients were tested using food allergy treatment. The patient’s serum was sent to screening tests developed by Dr. Michael Immuno Nutritional Clinical Laboratories in 92

Van Nuys, California 5 where it was analyzed for levels of IgE (RAST test), IgG (RAST test), IgE immune complexes, and IgG immune complexes for the suspected food(s).

pre-test findings and findings with the food in the mouth were recorded for all patients.

For several foods, only IgE and IgG are available. Patients were included in the study only when all four tests were available for the food(s) to which they showed sensitivity by neuromuscular hypersensitivity testing.

SEVERITY OF TYPE OF REACTION TOTALS REACTION IgE IgG E-IC G-IC

Table 2

EQUIVOCAL MODERATE SEVERE TOTALS

2 1 2 5

2 5 7 14

0 0 0 0

4 3 3 10

8 9 12 29

The laboratory reports results as either as reactive in one of three categories: equivocal, DISCUSSION moderate, or severe, or nonreactive. These results are included in Table 1 under The results suggest that applied kinesiology muscle testing procedures are an excellent “laboratory results”. screening test for positive IgE (Type I), IgG (Type II), and IgG immune complex (Type RESULTS III) mediated hypersensitivity reactions. The 17 patients with positive muscle testing percentage of positive laboratory findings findings had their blood tested for all four was 90.5% (19 of 21) of the foods which immune parameters. 15 patients showed showed positive to provocative muscle testing positive blood tests which paralleled their procedures. A 95% confidence interval of muscle testing findings. Four patients had (.777, 1.00) was calculated for the data. The two positive foods by muscle testing findings formula employed was: ... ‘d t\- Y I -n --” n which were compared with blood testing. where y = number of laboratory positives (19) Therefore, there were a total of 21 foods which n = number of foods tested (21). were muscle tested and blood tested. 19 of the foods which were positive to neuromuscular hypersensitivity provocative testing also showed positive blood tests. Further research is definitely indicated. Three specific directions are recommended. First, a self-controlled pilot study using muscle testing to identify both positive and negative hypersensitivity testing foods needs to be performed. This can tell us whether muscle testing is predicting only positives or if it can be used to identify non-reactive foods as well. Secondly, a multi-center study needs to follow up on this study and the one just proposed. Thirdly, follow up studies on The pre-test findings and findings with the patients who have already been tested as food in the mouth were included in the study positive with both muscle testing and blood to attempt to identify any diagnostic trends. testing should be performed after applied None were observed, but the data is included kinesiology desensitization techniques have in Table 1 also. Due to the nature of this study been administered. . The pilot study for being compiled based on regular patients in comparing both positive and negative muscle our office during regular office hours, not all testing findings with positive and negative The results are shown in Table 1. Of the 21 foods tested, the following positive reactions were found: IgE - 5, IgG - 14, IgE immune complexes - 0, IgG immune complexes - 10. The total number of positive blood reactions is 29 because a number of patients had multiple positive reactions. The severity of the reactions was as follows: equivocal - 8, moderate - 9, severe - 12. These findings are summarized in Table 2.

93

blood test reactions is being formulated in our office as of the writing of this paper. We are also planning follow-ups on as many patients in this study as possible following desensitization techniques. REFERENCES 1. Roitt, Ivan M., Brostoff, Jonathon, Male. David K. Immunology. St. Louis: C.V. Mosby. 1985. 2. Scopp, Al, An experimental evaluation of kinesiology in allergy and deficiency disease diagnosis. Journal of orthomolecular psychiatry 7:2, 1978. pp. 137-8. 3. Lebowitz, Michael, A technique to abolish all food sensitivities. I.C.A.K. collected papers, 1988-89, volume II. 4. Schmitt, Walter H., Jr. Applied kinesiological observations of allergic patients - Parts I and II. Digest of chiropractic economics 27: 1, JulyAugust, 1984 and 27:2, September-October, 1984. 5. Immuno Nutritional Clinical Laboratory, 6700 Valijean Avenue, Van Nuys, California 91406. (818) 780-4720.

94

TABLE 1 PRE-TESTING FINDINGS

WITH FOOD IN MOUTH LABORATORY RESULTS

Thy- Cu+ Cop pt



Yak.

Cu

mus

Thym Out

Food

Yak Thym Liv

1.

S

0

0

0

0

+

0

+

2.

0

W

0

S

0

MILK

0

+

0

3.

S

S

0

S

W BR. YEAST

+

0

4A.

0

0

0

S

W

+

4B

”

“

“

“

“

MILK

5.

0

S

0

-

W

MILK

6.

0

0

S

-

7.

0

S

0

8.

S

S

9A.

0

9B.

CTS

IgE

IgG-

E-IC

CCW E

E

0

0

CCW S

S

0

0

0

CCW 0

S

0

E

0

+

CCW 0

M

0

E

+

0

+

CCW

S

M

0

0

0

+

+

0

M

0

M

W BR. YEAST

0

+

+

CCW 0

S

0

M

-

0

0

+

+

CCW 0

S

0

0

0

-

W BR. YEAST

+

0

0

CCW 0

S

0

0

0

0

S

W

CORN

0

+

0

CCW 0

M

0

0

”

“

“

“

“

MILK

0

+

+

CCW M

S

0

E

10.

0

0

0

S

W

0 +

+

CCW 0

S

0

E

11.

0

NA

NA

NA

NA

CORN

12.

0

0

0

S

NA

*CORN

13.

0

0

0

S

W

14A.

0

S

S

-

W

14B.

“

“

“

“

”

CORN

NA +

15.

0

0

0

S

W

WHEAT

16.

NA

S

NA

NA

NA BR. YEAST

17A.

S

0

0

S

NA

17B

”

“

“

“

“

TOT

16

16

15

15

13



S=4

S=6

S=2

S=9

W=10

G-IC SOYBEAN

WHEAT

BR. YEAST



BR. YEAST

0

+

0

+

NA

0

0

0

S

NA +

NA

NA

0

0

0

0

CORN

NA +

NA

0

0

0

MILK

NA +

NA

CCW 0 )

E

0

0

0

0

CCW

0

E

0

0

NA +

NA

CCW 0

M

0

0

NA +

NA

CCW 0

0

0

M

CORN

NA 0

NA

NA

0**

0**

0

S

WHEAT

NA +

NA

NA

0**

0**

0

S

17

21

21

21

21

14

0

10

W=1

13 21

14

+=5 +=15

+=9

CCW=15 5

)=1

* Corn oil only weakened; cornmeal tested OK

** General screening test for 6 grains including corn and wheat PRE-TESTING FINDINGS Yak. = Antronex in mouth strengthens a weak muscle

Cu = Copper in mouth strengthens a

weak muscle Cu+Thymus = Copper in mouth plus T.L. to thymus

Cop Out = Cop Out in mouth plus thy-

mus T.L. Thymus = T.L. to thymus (angle of Louis) strengthens a weak muscle S = Strengthens

W = Weakens a = No effect on muscle

strength NA = Not tested

- = Not applicable since copper strengthened

weak muscle WEAKENING FOOD IN MOUTH FINDINGS Yak = Antronex in mouth

Thym = Thymus T.L.

Liv = Liver NL T.L.

+ = Negated weakening effect of food in mouth

CTS = Centering the spine-spinal position which negates food induced weakness CCW = Counterclockwise pelvic torque negated weakening effect of food in mouth ) = Lateral flexion convex to left negated weakening effect of food in mouth LABORATORY FINDINGS IgE = IgE RAST test IgG = IgG RAST test

95

0 = Non-reactive E = Equivocal positive reaction

E-IC = IgE Food Immune Complex Assay

M = Moderate positive reaction

G-IC = IgG Food Immune Complex Assay

S = Severe positive reactiousing

Oral or olfactory testing of nutrients is one of the controversial elements in applied kinesiology due to its abuse.

no relation with thyroid function. One had nutrients related to thyroid production. The nutrients were tested by insalivation and by holding them in the hand. These vials were masked and labeled A, B, C, and D with The system of nutrient testing for both positive neither the tester nor the person doing the and negative effects has been misrepresented testing knowing the ingredients. The results by both professionals and non-professionals. of this test were as follows: Demonstrations of holding substances, pointing at them, visualization, or of having 1. There was no strengthening of the the testing person hold the substance are teres minor by holding the nutrients in commonplace. the hand 2. Those patients who reported less than To test for this, a study was done using a 4 symptoms out of 25 did not show poisonous substance, The testing method was any correlation with the supplement that four different sample groups masked so designed to aid thyroid function. that the persons doing the testing and those 3. Those who marked between 5 and 20 being tested would not know what was in the of the symptoms related to thyroid bag. There were four containers, one of which malfunction tested positive for the contained the poison. A strong muscle, the nutrient. rectus femoris was tested and the person being 4. Those who marked over 75 percent of tested held the masked container against their the symptoms, 23 or more out or 30, solar plexus, a common place used by those tested positive for 2 or more of the using muscle testing in this manner. All four nutrient supplements. samples were tested and the results recorded by another person. Neither the testing person The proper use of muscle testing to aid in or the person being tested knew whether they nutritional work depends upon knowledge were testing sample A, B, C or D. of physiology, diagnosis, pathology and biochemistry. Doctors with over 5 years of experience testing muscles tested over 300 persons. There was no Goodheart coined the phrase 51 percenter. The correlation between muscle weakness and the changing of the strength of a muscle means poison sample. This paper is being prepared little in itself. The change in the function of for publication. the muscle must be correlated with other findings. Triano published a paper showing no correlation between the latissimus dorsi and Finding a weak latissimus dorsi, related nutrients that were supposed to be related with the pancreas, could mean a problem to that muscle. The substances chosen were with blood sugar maintenance, but it could whole food products consisting of many macro also indicate an injury to the muscle itself, a and micronutrients. They were chosen from a problem with the nerve supply to the muscle, list produced by a company that related specific a reflex inhibition related to plantar muscle nutrients with specific muscle weakness. contraction, or even a problem with the production of digestive enzymes. Leaf published a paper with the following design. Persons with a weakness of the teres minor were asked to fill out a questionnaire with 30 possible symptoms related to thyroid dysfunction. The subjects were then tested with four different nutrients. Three had 96

Melzack & Wall Gate Control Professors Ronald Melzack and Patrick Wall, of Montreal and London, proposed in 1965 that painful stimulations traveling up the spinal column are modulated by a gate mechanism. If the gate is open, all of the nerve impulses are allowed to pass, and if the gate is closed or partially closed, then only a few or none of the impulses are allowed to pass. Pain is transmitted up the spinal column by the activation of the T cell, and this cell can be activated by either large of small fibers. Cells in the substantia gelatinosa (SG cell) can inhibit of block the transmission of the T cell thereby acting as a "Gate". The SG cell is activated by the large diameter fibers, the A-beta fibers. These are stimulated by light touch or vibration. The small fibers, C fibers, are stimulated by heavy pressure or painful stimulation. These fibers activated the SG cell opening the gate and allowing passage of the painful sensation to the brain. 1. Nerve impulses from the afferent fibers to the spinal cord neurons are modulated by a spinal gate mechanism located in the substantia gelatinosa of the dorsal horns. 2. The gate mechanism is influenced by activity in the large and small diameter fibers. Stimulation of the large fibers inhibits the transmission by closing the gate. Small fiber activity opens the gate facilitating nerve transmission. 3. The brain influences the gate mechanism through efferent fibers.

6. The gate regulates the amount of information going to the brain. 7. Pavlov observed that afferent signals from the nervous system must be identified, evaluated in relation to prior experience, localized and inhibited before the action system for pain perception and response is exceeded by the dorsal horn transmission neurons. Goodheart discovered that stimulation of certain acupuncture points would exhibit an inhibitory reaction at the spinal gate and thus help to control pain. Do a pulse diagnosis to determine the meridian imbalance. In pain patients, you will usually find only one meridian out of balance. Test to find the deficient side as exhibited by the weak associated muscle. Tap the tonification point four to five times and retest the weak muscle for strengthening. If the weak muscle strengthens, tap for two to three minutes and test for a reduction in pain. You may have to tap the associated point for the meridian along with the tonification point to achieve results. If this reduces pain, stimulation of the sedation point will cause the pain to return. If normal therapy localization does not disclose a known problem, pinch or spray, with a coolant spray, the dermatome over which the suspected problem exists. These actions will open the spinal gate and aid in finding hidden problems.

In treating chronic problems, the brain may contain a pattern of memory that needs to be 4. At higher levels, there exists a central control accessed to complete treatment. For example, of large diameter, rapid conducting fibers, that if you cut yourself in opening a letter, the first modulates the spinal gate through cognitive thing that you do is to move your other hand processes. to protect the injured hand. The second action is head orientation towards the area injured. 5. When a threshold level over the spinal cord This action is followed by looking at the area. transmission neurons is exceeded, an action Vocalization is the next sequential action and system is activated that produces set patterns this is followed by remembering a similar injury of behavior and experiences of pain. from the past. 97

In a chronic problem, therapy localize the area and treat all indicated reflexes. Then, have the patient therapy localize and with the head turned towards the area look at the area or in that direction and retest. The area should now therapy localize and if it does, retreat all reflexes. This action is followed by having the patient looking at the area and opening their mouth as to speak and again retesting and treating if indicated. The final procedure is to have the patient therapy localize, look at the area, open the mouth, and finally think of the injury and retest and treat all indicated reflexes.

To the brain

Stimulation of the large fibers by vibration (tapping) closes the gate mechanism

Large fibers (A - beta)

Pain

A - delta fibers

Small fibers (C)

98

Stimulation of the small fibers by pinching or cold opens the gate

Mental Recall Goodheart states that if emotional or physical trauma is out of the awareness of the body, the body cannot repair it.

2. Have the patient visualize the trauma and retest for weakening. Observe the eyes for rapid eye movements (REM'S).

After correcting all imbalances in a chronic area, 3. Hold the neurovascular contacts for consider that the mind may not be aware that emotional stress above the orbits. Palpate a problem exists. For some reason the trauma for a pulsation. has been blocked. 4. Ask the patient to again visualize the Ask the patient to remember the first instance trauma and imagine that they have a of pain or trauma. Treat any structures found movie of their life. Place the images in the weak while the patient is remembering the movie where they belong and then turn trauma or occurrence of symptoms. the projector on fast forward and quickly go through their life until they reach the This mental recalling of the emotional event present. Have them open their eyes when aids the mind in the correction of the problem if they reach the present. the structural corrections are performed while the recall is being done. 5. Visualize the trauma again and test for weakening of a strong indicator muscle. It 1. Test and treat all weaknesses and spinal should now test strong. imbalances. This technique appears to remove the psycho2. Have the patient recall the trauma, either somatic link between the emotional stress and emotional or physical, and retest for the the physical body. weak indicators. 3. Treat all returning weaknesses while the patient think of the trauma. 4. Retest again with emotional recall. In a seminar in Boston, Goodheart treated a doctor who had been attacked and ended up losing the sight in one eye and having chronic sciatica. He treated the doctor and obtained excellent results using structural corrections to the pelvis and lumbar spine. The next month when he returned, he asked the doctor how he was doing. He responded that he had complete relief for two weeks and then the pain in the leg returned. Instead of retreating the lumbar spine, Goodheart performed the following: 1. Test and find a strong muscle. 99

Injury Recall Technique Walter H. Schmitt, Jr., D.C., DICAK, DABCN The following procedures were developed and presented to the ICAK by Walter Schmitt. They are presented here to show how members develop a concept, apply it in their office, share it with other members of the organization and then present them to the Scientific Review Board of the ICAK to be tested and voted on to become part of the approved subjects in applied kinesiology. As of the writing of this book, these procedures are in the validation process of the Scientific Review Board awaiting final approved status.

Does “Autogenic Facilitation” Strengthen Weak Muscle(s)? 1 .If Autogenic Facilitation (Stretching of Muscle Spindle Cell) Strengthens: No IRT Needed 1. If Autogenic Facilitation Does Not Strengthen: Identify Areas Needing IRT by Doctor Rubbing (or Patient TL) Over Areas of Injury (Past or Present) 2. Perform IRT to Areas Identified.

3. Retest for Response to Autogenic Facilitation a. If Autogenic Facilitation Injury Recall Technique (IRT) was taught Strengthens: to me by my friend, Dr. Gordon Bronston, a Go to NSB / Set Point Technique Southfield, Michigan podiatrist. Because it (If Needed) has immense clinical value and is practiced b. If Autogenic Facilitaton Does Not by only a handful of podiatrists, I adapted the Strengthen: Repeat Steps 2 technique in the late 1980s for use by other through 3 health care practitioners. 5. Continue Until Autogenic Facilitation Dr. Bronston taught me that “the single most Strengthens Weak Muscle(s) important factor in a patient’s history is the history of injury and trauma.” I have learned NOTE: MEASURE, MEASURE, MEAthat IRT is not duplicated by any other techSURE – Perform RANGE OF MOTION and/ nique. In my clinical experience, IRT has been present in about 80% of my patients. In or MEASURE PAIN (Pain Scale: 0 – 10) these patients, about 80% of their previous in Before and After Performing IRT. juries responded to IRT. Although these are just general numbers, they give the idea of the widespread value of applying IRT. The following is excerpted with permission from: McCord, KM, and Schmitt, WH, Quintessential Applications: A(K) Clinical Protocol. St. Petersburg, Florida: Privately Published, 2005.

100

IRT DIAGNOSIS for HEAD & NECK PROBLEMS 1. TL to Area of Previous Trauma on the Head or Neck is Negative. 2. TL to Same Area with Head & Neck In Extension Weakens Strong Muscle. IRT TREATMENT for HEAD & NECK PROBLEMS: Firmly, but Gently, FLEX THE ATLANTOOCCIPITAL AREA, to the Limit of Motion, Three or Four Times: A. While Patient Touches Area of Previous Injury (or) B. After Doctor Pinches Area of Previous Injury (or) C. After Doctor Uses Origin-Insertion Technique in Area of Previous Injury IRT DIAGNOSIS for the REST OF THE BODY:



Gently COMPRESS THE MORTIS JOINT (Push Talus Headward) A. While Patient Touches Area of Previous Injury (or) B. After Doctor Pinches Area of Previous Injury Observe for Strong Muscle Weakness



101

IRT TREATMENT for the REST OF THE BODY: Perform a DISTRACTION (Micromanipulation) OF THE TALUS (Opening Mortis Joint) A. While Patient Touches Area of Previous Injury (or) B. After Doctor Pinches Area of Previous Injury (or) C. After Doctor Uses Origin-Insertion Technique in Area of Previous Injury



IRT for the SPINE: Cervical Spine and Coccyx – ATLANTO-OCCIPITAL FLEXION A. While Patient Touches Cervical Segment or Coccyx (or) B. After Doctor Pinches Skin over Cervical Segment or Coccyx

Sacrum, Sacroiliacs, and the Rest of the Spine – DISTRACTION OF THE TALUS A. While Patient Touches Sacrum, Sacroiliac or Spinal Segment (or) B. After Doctor Pinches Skin over Sacrum, Sacroiliac or Spinal Segment Perform IRT Bilaterally or Ipsilaterally (e.g. Sacroiliac) as Appropriate

Alternative Pain Control Technique Using the concepts developed by Goodheart, Schmitt has developed an alternative method for controlling pain. This is a combination of treating acupuncture meridians begin with using mental processes to access specific areas of the brain. Schmitt found that the points on the skull where meridian begin or end are effective treatment areas when the patient is in pain.

If the aggravation of the area does not cause weakening of a strong muscle, have the patient therapy localize to the area and test for weakening of a strong muscle. If it fails to weaken, tap the head acupuncture points until one is found that weakens the strong indicator muscle. This is the point that should be treated.

Schmitt has added the concepts of thinking of His basic procedure is to aggravate the area the pain, thinking of the memory of it and the where the pain is located and test for weaken- emotion of it as ways to access different areas ing of a strong indicator muscle. The patient’s of the brain that are then treated by tapping finger is then placed over one of the acupunc- the point found in the procedures above. ture points on the skull or the doctor taps the point until one is found that strengthens the Following this are the notes used by Dr. weak muscle. This is the point that needs to Schmitt in teaching this technique. be tapped.

Bladder 1 Gall Bladder 1 Triple Warmer 23 Small Intestine 19 Stomach 1 Large Intestine 20

Governing vessel 27 Vessel of conception 24

102

103

Acupunture Meridian Head Points Pain Relief Techniques Walter H. Schmitt, DC, DIBAK, DABCN NOCICEPTOR STIMULATIONBLOCKING TECHNIQUE FOR ACUTE PAIN CONTROL 1. General muscle weakness is created by: a. Acute pain b. Pressure to a painful area c. Putting a joint into painful position 2. Patient TLs to ipsilateral acupuncture head points. One head point will negate general weakness. 3. Tap head point with 1a, 1b, or 1c. 4. Continue tapping with 1a, 1b, or 1c until pain relief is maximized. 5. 1a, 1b, or 1c will no longer cause muscle weakness

SET POINT TECHNIQUE (“TOUCH AND TAP TECHNIQUE”) 1. Patient TL to the area of pain or previous injury is negative. 2. Patient TL to area PLUS tapping on one B&E point (ACUPRESSURE TAPPING POINT) on the same side of the body causes strong muscle to become inhibited. 3. Tap the related B&E point (ACUPRESSURE TAPPING POINT) on the same side of the body while the patient maintains contact with the area of pain. 4. Tap 100 times. You may tap more if doing so increases pain reduction further.

LQM (LOCATION, QUALITY, & MEMORY) TECHNIQUE LOCATION OF THE PAIN (SOMATOSENSORY AREA OF CEREBRAL CORTEX) 1. Have patient focus attention on a specific location in the body. 2. If strong muscle weakens: TL to acupuncture head points while patient continues to think about that part of body. One acupuncture head point will neutralize muscle weakness caused by focusing process. 3. Tap that head point 50 - 100 times while patient continues to focus attention on body part.

104

4. Recheck 1. and test strong muscle to ascertain correction. QUALITY OR NATURE OF THE PAIN (SOMATOSENSORY AREA OF CEREBRAL CORTEX) 1. Have patient focus attention on the quality of the pain. 2. If strong muscle weakens: TL to acupuncture head points while patient continues to think about the quality of the pain. One acupuncture head point will neutralize muscle weakness caused by focusing process. 3. Tap that head point 50 - 100 times while patient continues to focus attention on the quality of the pain. 4. Recheck 1. and test strong muscle to ascertain correction. MEMORY OF THE PAIN (TEMPORAL LOBE) 1. Have patient focus on:

a. memory of pain when it was at its worst, or b. memory of incident when pain began.

2. If strong muscle weakens: TL to acupuncture head points while patient continues to think about than memory. One acupuncture head point will neutralize muscle weakness caused by the memory of the pain (or incident causing pain.) 3. Tap that head point 50 - 100 times while patient continues to think about memory of pain (or incident causing pain.)

105

4. Recheck 1.a. or 1.b. and test strong muscle to ascertain correction.

Proposed Neurological Mechanisms for A.K. Pain Relief Walter H. Schmitt, DC, DIBAK, DABCN

Nociception has three effects in the spinal cord: 1) transmission of the nociceptive message to higher levels; 2) flexor reflex afferent muscle response; and 3) excitation of intermediolateral cell column (IML). Mechanoreceptor (MR) activity blocks each of these three effects of nociception in the spinal cord. (Note: Only the MR inhibition of transmission to higher levels is shown in the drawing below.) The flexor reflex afferent response lays the theoretical foundation for the use of muscle testing procedures to evaluate the effectiveness of various pain relief therapies. That is, when a test stimulus of the appropriate pain relief therapy is used, it will result in a strengthening response of an inhibited muscle. Continued application of that therapy has shown to result in significant pain reduction.

effective (and usually more effective and faster) for meridian pain relief techniques than acupuncture needling techniques. The pathways diagramed for nociception provide the theoretical basis for the clinical application of NSB Technique, Set Point Technique, and LQM Technique. Presumably, each of these techniques activates at least one of these pathways. When a particular pain relief therapy is needed, activation of the appropriate neurons by a challenge procedure specific to those neurons will result in positive muscle testing findings, usually general muscle inhibition resulting in muscle testing “weakness.” Tapping ipsilateral acupuncture meridian head points has shown to be among the most effective therapies to relieve pain and restore normal function. However, to be effective, the points must be tapped in conjunction with some other nociceptive related activity. Said differently, a group of neurons along the nociceptive pathway must be brought to firing threshold simultaneously with tapping the meridian points in order for tapping to be effective. The nociceptive related activity is different for each of the above three techniques. Firing the appropriate neuron pools with the simultaneous meridian point tapping results in pain reduction as well as changes in muscle testing responses, ranges of motion, etc. The appropriate neurological stimulus for each technique is:

Activation of MRs can be achieved by tapping the skin, usually at a rate of about four to five times a second. Tapping at this rate causes a repetitive stimulation of MRs including those that are rapidly adapting. At this rate, tapping 100 times requires 20-25 seconds. In the 1970s, Goodheart observed that tapping of acupuncture meridian points was at least as 106

1) NSB technique: presence of acute pain, either immediately after injury occurs or by inducing pain by pressing on the area or moving it into a painful range of motion 2) Set Point (Touch and Tap) Technique: patient touches the area of pain 3) LQM technique: patient consciously activates neuron pools by thinking about the location of the pain, the quality of

the pain, and the memory of the pain. There is often an anatomical relationship between the pain location on the body and the meridian head point to be tapped. The body location is near or on the ipsilateral acupuncture meridian related to the head point (yang meridian) or its coupled meridian (yin meridian) in about 75% of cases. (For example, the Large Intestine-20 point is often related to a body location near or on the large intestine meridian or the lung meridian.) The other 25% of the time, there is no anatomical relationship between the meridian head point and the body location of the pain. In all cases, the meridian head point to be tapped is found by the muscle testing procedures described above. The acupuncture meridian head points receive their sensory innervation from the trigeminal nerve and synapse in the spinal (descending) trigeminal nucleus in the lower medulla and upper cervical cord. The sensory facial fibers closer to the mouth synapse more rostrally in the spinal trigeminal nucleus and those farther away from the mouth synapse more caudally in the spinal trigeminal nucleus. Considering this sensory orientation of the facial tissues, these meridian points follow a more or less somatotopic segmental distribution from LI-20 extending centrifugally to SI-19.

the body when the nociception reaches a still higher threshold. NSB technique is indicated when elevated levels of nociception result in a weakness of muscles throughout the body to muscle testing, presumably since the acute levels of nociception achieve the level necessary to create general muscle inhibition as in 3) in the previous paragraph. The nociception-induced muscle testing weakness is negated by stimulation of the appropriate ipsilateral acupuncture meridian head point. Perhaps NSB helps to activate a sluggish self-limiting reflex pathway through the CRN. Set Point (Touch and Tap) Technique Set Point (Touch and Tap) Technique is indicated when a change in muscle testing response (weakening of a strong muscle) results when the patient simultaneously touches the area of pain or injury (paralleling the instinctive response of touching the area that hurts) and the acupuncture meridian head point. Location, Quality, Memory (of the Pain) Technique

LQM technique depends on the patient’s conscious activation of various cortical neuron pools by mentally focusing on the location of the pain (visceral or somatosensory cortex), NSB Technique the quality of the pain (visceral or somatosensory cortex), and the memory of the pain There is a self-limiting nociception reflex arc (temporal lobe.) LQM technique is indicated from the spinal cord to the caudal reticular when mentally focusing on one or all of these nuclei (CRN) and then back to the spinal cord. cortical pain related areas creates a muscle Incoming nociception excites CRN neurons testing weakness that is negated by simultawhose descending axons inhibit the nocicep- neous stimulus of the acupuncture meridian tion at the spinal cord level. This is presum- head point. ably one of the pathways that is activated in these pain relief techniques, especially NSB. Any or all of these pain relief techniques may Increasing levels of nociception cause, in be indicated in a patient. Muscle testing acascending order: 1) flexor reflex afferent re- companied with sensory or mental challenges sponse with excitation of flexors and inhibi- of the various neuron pools guides the clinition of extensors near the nociceptive source; cian the most effective combination of these 2) a “splinting” facilitation of both flexors and and other pain relief therapies. extensors around the nociceptive source; and 3) a general inhibition of muscles throughout 107

Inflammation & Prostaglandins

108

Applied kinesiology testing is an ideal way to Arachidonic acid – found in dairy fats can be analyze the biochemical pathways of the es- used to increase the pain so that both oils can sential fatty acids. be tested. Using specific muscle tests, muscles related to the cofactors can be tested to determine the need for supplementation. Grip strength or neck flexors - B-6 Sternocleidomastoid – niacin Pectoralis minor – zinc Subclavius – magnesium The individual omega oils – 6 and or 3 can then be insalivated and the local pain can be palpated for reduction.

109

You may find that the patient requires one or both oils to stabilize their symptoms. The chart below shows the biochemical pathways and the cofactors that are necessary for the transformation of the essential fatty acids into their prostaglandin end products.

110

Appendix A Partial List of Additional Procedures taught and developed in Applied Kinesiology Muscle Related Therapies Antagonist Reactive Muscle Pattern At one of the annual meeting of ICAK in the 1980's, Deal presented the idea that a muscle could be "frozen". In effect, the muscle could not be turned off by the usual means due to the under contraction of its antagonist. This condition leads to a loss of range of motion due to the failure of the antagonist muscle to relax. Proper testing and treatment leads to normalization of motion. Ligament Interlink Coordination of walking is a spinal cord function. Goodheart discovered a spinal cord reflex that is involved with gait that appears to relate opposing ligaments. This research was developed from material first presented in Scientific American on the motion of limbs in a decerebrated cat.

activity. Imbalances in these receptors create muscular imbalances that lead to the continuation of many structural pain patterns. From the work of Montegue on the skin, diagnostic and treatment options were developed for correction of muscle inhibition patterns created by involvement of the skin or by scars. It is a common practice in Europe to treat scars when there is localized pain or joint malfunction. Gait Testing Walking and running require coordination of motion between opposite extremities. As part of the compensatory mechanism of the body to react to fixations and other imbalances, these coordinated activities are altered.

Goodheart found that you could test for the proper functioning of these joint actions by testing the opposing extremities. The tests are performed in the cardinal motions of flexion, extension, abduction, adduction and the rotational There is a relationship between a ligament on motions caused by the opposing contractions of one side of the body to a corresponding ligament the abdominal oblique and the gluteus medius in a contralateral joint of the body. and the psoas and the pectoralis sternal. Proper treatment leads to reduction in ten- Proper treatment leads to a normalization of derness and localized pain over the involved the walking patterns of gait facilitation. ligaments. This has been demonstrated by Synchronization reduction in temperature over the involved ligaments In the 30’s and 40’s, a chiropractor, Watkins, began the advocacy for treating areas that appeared to help coordinate the function of the Skin is the largest organ of the body. Proprio- head and pelvis. He described areas perianally ceptors in the skin tell us where our joints are that effect muscle balance along the spine. and are involved in the inhibition of muscular These appear to be related to other “righting” Skin - Scars

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reflexes that are well documented.

Gait Inhibition

Goodheart made the observation that when the visual reflexes are in need of treatment, muscles will test weak with the eyes open but strengthen with the eyes closed. He related this to a carry over effect from trauma. If the patient is questioned as to the position that they were in when the trauma occurred, they will relate a position where these muscles are inhibited. It appears that the injury “locks in” this inhibition pattern.

During the normal walking pattern, muscles are inhibited to allow normal motion to occur. After injury or when fatigue starts after strenuous activity, this normal inhibition process may not occur properly. This leads to continual contraction of the muscle that fails to inhibit. This can easily be seen by a failure of motion of an arm, or a slight pulling of the head towards one side.

Proper therapy allows normal functioning of the muscles whether the eyes are open or closed and aids in normalization of gait as well as other body mechanics.

Failure of proper inhibition can involve single muscles, muscles from a single spinal level or a complete side. Proper correction allows normalization of the proper inhibition pattern.

Right - Left Brain Activity There is a definite difference in the function of the right and left brains. The right side of the body receives at least 85% of its control from the left brain and the left side the same percentage from the right brain.

Biological Closed Electrical Circuit

Nordenstrom, of the Karolinsk Institute in Stockholm, has shown that the blood vessels function as electrically conducting cables. This The left side of the brain is basically logical, appears to be the upward communication link systematic, mathematical, lingual, etc. A from the periphery to the brain. For example, bookkeeper or computer programmer is an the brain receives information molecules proexample of a strictly left brain activity. The duced by white blood cells that modulate brain right brain is illogical, nonsensical, tonal, activity. This is the work of Pert. musical, emotional, creative, etc. Everything the opposite of the left brain. Artists are Nordenstrom has found that using electrical currents along the arteries, he has been able examples of right brain dominant people. to reverse inoperable cancers. James Pershing Isaacs wrote about the use of homeopathy in Europe and found that very low dosages of nutrients would appear to balance brain function. From these observations, Goodheart advanced these thoughts to show that specific nutrients would positively effect the different sides of the brain.

The kinesiological indication for this technique is when repeated testing of a muscle causes weakness and does not respond to nutrition or lymphatic reflex contacts. If this pattern is found in an extremity, all muscles from the one distally will test weak for this pattern. For example, if the communication is blocked Using these concepts, nutrition, cranial work at the knee, all muscles from the popliteus and spinal work can be used to help patients distally would test weak on repeat testing, but with conditions like stroke, multiple sclerosis, the quadriceps would not. learning disabilities, ADD, etc. Goodheart found a manual correction for this condition. 112

Repeated Muscle Activation (RMA) Golgi tendon organs are located near the musculotendinous junction. To understand the function of these structures, realize that they are arranged in a series with the extrafusal muscle fibers so that if the muscle is stretched or contracted, the tendon organ will be stimulated. Following the observations of Leaf that hidden muscle weakness patterns could be found if the patient was asked to activate the muscle repeatedly, Goodheart found that many muscles that would give the physical signs that they were weak would test strong. However, after having the patient activate the muscle 10 times, these muscles would then test weak.

until the fixation pattern has been corrected.

Hologramic Subluxation When abnormal stresses are applied to bone, the bone will bend. This phenomenon is a contributing factor in scoliosis and the production of genu valgus deformities. This is also the underlying cause of bent spinouses. Studies have shown that there is an ion change in the crystalline structure of the bone where this deformity exists.

Classically, when these subluxations are found, Goodheart found that over 90% of the patient's the bone will be very tender to palpation where showing this muscle weakness pattern showed the bone would bend. It is this small intense area of tenderness that is indicative of this occipital or spinal fixation patterns. problem. You will usually find a decreased range Correction involves both a structural correc- of motion in a body part innervated from the tion to the muscle and testing for a nutritional area or related structurally. After correction, the range of motion improves dramatically. component

Spinal Related Therapies

Category I & II

For decades, Dr. Major DeJarnette discussed three types of pelvic problems. He named A muscular locking of three vertebral struc- these conditions Category I, Category II and tures, or the ilium and the sacrum, thus re- Category III. stricting normal motion. Category I is a locking of the sacral boot In the spine, the rotatory longus and brevis mechanism that is involved with the flow on one side are found in contraction causing of cerebrospinal fluid. There is no osseous rotation of the vertebrae towards the side of misalignment or subluxation of the sacroiliac contraction and thus restricting normal motion. articulations. If an osseous misalignment or subluxaiton exists, it is called a Cetgory II pelvic imbalance. This was discussed in the Goodheart found that these can be diagnosed main section of this book. because of specific muscle weakness patterns that are found associated with each spinal area. Goodheart developed a diagnostic system to find these conditions that can be used in This allows testing for the existence of the different postural positions. He and others fixation pattern but also confirmation that the in the AK community have developed fixation has been properly manipulated. The improvements in the standard treatments for muscle weakness pattern will not test strong these conditions. Vertebral Fixations

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Meningeal Release - Coccyx Category III

The dura mater is firmly attached inside the The Category III problem was described by cranial bowl, at the upper cervical area and DeJarnette to be a pelvic imbalance that had then again at the sacrum and by the filum terminale into the coccyx. an accompanying sciatic neuralgia. For years, Goodheart had difficulty integrating this problem into the pattern of correction used in Applied Kinesiology. In 1991, he developed a procedure to correct this problem.

In coccyx imbalances, abnormal stress can be applied to the dura mater causing reflex muscle tension along the spine. Goodheart, following the works of Lowell Ward, has described the coccyx as a take up mechanism to keep constant tension on the dura mater.

Sacral Wobble There is a torque pattern of motion that occurs at the sacrum during normal walking. This resembles a figure 8.

Spondylogenic Reflex

Goodheart was given a book Manual Medicine by Dvorák and Dvorák, two Czechoslovakian This pattern was originally described by physicians working in Berne, Switzerland. In Goodheart in the early 70’s, and specific their book, they describe an interesting exmanual corrections developed to normalize periment where they irritated the facets of the this motion. Later in the 80’s, the importance spine and recorded hypertonicity in sections of of the function of the piriformis in controlling muscles in the back. These experiments also and supporting the sacrum and the sacroiliac showed that the hypertonic patterns extended joint added to the understanding of this to the muscles of the skull, eye and extremities. The intriguing part was that each spinal condition. segment had a specific group of muscle sections that would become contracted by the irritation Iliolumbar Ligament of the facets. Based on the concepts of Fred Illi, D.C. following his work at National College of Chiropractic For years, Goodheart studied this book and in Illinois, Goodheart became interested in the tried to put the information to use. It wasn't until he combined a few procedures that he function of the iliolumbar ligament was able to find and correct these imbalances. Goodheart made the observation that imbalances, elongation, in this ligament caused improper inhibition patterns when the patient was tested in a gait position. Leaf later showed how to diagnose entrapment of the L - 5 nerve due to shortening of this ligament. Consequently, alterations in this ligament can cause gait imbalances or sciatic nerve type symptoms when the patient is in a twisted position.

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Cervical Compaction Barry Wycke, a noted English neurologist, developed a screening test to determine chronic imbalances in the cervical spine. This test appears to uncover hidden imbalances in the mechanoreceptors. This test was developed to fill a need to determine if cervical imbalances existed following auto - cervical spine injuries. It aids in finding if imbalances do exist and screens

for malingerers. As discussed by the Dvorak 's in ,Manual Medicine, this test coincides with imbalances in active and passive range of motion. These imbalances are due to alterations in the functioning of the mechanoreceptors of the cervical spine. This is of great importance as imbalances in these structures cause chronic pain patterns. Using the diagnostic test of Wycke, Goodheart developed a treatment to normalize the mechanoreceptor function thus normalizing ROM and reducing local pain patterns. Leaf later demonstrated that this condition can be found in other joints in the body. Hidden Cervical Disc

no rotation, the vertebral bodies would jam into each other. This rotation occurs because of inhibition of the piriformis. Everyone, in a normal condition, will have the right piriformis inhibit at approximately 30 degrees of lumbar flexion. This same inhibition pattern occurs in extension. This pattern of muscular inhibition continues up the spine. The left latissimus, the left upper trapezius and the right sternocleidomastoid muscles inhibit at the same degree of lumbar flexion and extension. When the inhibition pattern fails to occur, have the patient therapy localize to problems in the pelvis and the upper cervical area. When an uncorrected problem is found, the muscles will inhibit and test weak.

The cervical spine is not as prone to disc herniation as the lumber spine. However, the cervical spine does present with a special type of lesion Piriformis Gait Inhibition coined “hidden cervical disc” by Goodheart. This problem creates a special type of symptom pattern. As part of the gait inhibition pattern when walking, the piriformis is inhibited. This is in In the cervical spine, the sensory and the motor addition to the inhibition that occurs in the roots do not merge until after the interverte- PLUS technique when the lumbar spine is bral foramina. This causes patients to present flexed 30 degrees or extended 20 degrees. with more varied symptom patterns than in the lumbar spine. Goodheart noted that while he was trying to do the PLUS testing, he would sometimes In this condition, the vertebrae slide up the line obtain aberrant findings. These occurred of the facets. This causes an anterior superior when the patients would move their arms. misalignment of the vertebra and results in a Further testing showed that the piriformis bulging of the disc. This discal pressure may and the iliacus will be inhibited in a gait effect only the motor nerve root or may cause position. This will occur when the opposite cord pressure. arm and leg are brought forward into flexion. This pattern occurs on both sides because it is a part of normal walking. P. L. U. S. This inhibition follows the pattern that Illi Illi made many important discoveries about the first wrote about. He was the first to describe mechanics of the lumbar and pelvic areas. One that as the ilium moves forward, the fifth of these was further developed by Goodheart lumbar moves forward on that side and the and became a technique for determining if there sacrum moves backward. This motion is are any hidden problems that are restricting limited by the iliolumbar ligament, but it is normal spinal mechanics. the inhibition of the piriformis and the iliacus that are the causative factors. When you bend forward, the lumbar spine does not just flex. It also must rotate. If there was When the muscles fail to inhibit, there will be 115

a hidden sacral, iliac or fifth lumbar fixation complex.

Pitch Roll Yaw-Tilt

Upledger, in his classic Craniosacral Therapy, describes a procedure for decompressing the jugular foramen. This procedure causes relaxation of all of the sub-occipital muscles and normalizes the flow of cerebrospinal fluid through the foramen magnum.

This procedure is useful in correcting imbalances in pelvis vs. skull positions. One follows the other as a tanker aircraft is locked into pattern with a refueling plane. Based on his military aviation background, Goodheart found that there are many imbalances between the motions of the head and of the pelvis.

Goodheart has noted that when this procedure needs to be performed, there will be a lateral deviation of the uvula to one side. This is due to interference with the glossopharyngeal nerve. Imbalances in the vagus nerve can be seen when levator palatini rises higher on one side than the other when the patient is asked to say "AH".

He developed a series of tests that stress these coordination patterns and corrective procedures for them. These are common findings in the chronic patient that resists correction.

This procedure is beneficial whenever there are potential imbalances in the functioning of the cranial nerves that exit through the occipital bone. It also appears to reduce stress on the jugular vein and reduces venous intracranial pressure.

This is an excellent tool to find hidden problems in the spine.

Stride Length A Japanese researcher, named Isogaii, asked the question "Why do some people get the same pains back over and over?" He studied these people for over 40 years. His conclusion was very simple. They walked wrong. They had one stride longer that the other. This caused a torque to be applied to the spine and the muscle structure. Over years, Goodheart took this simple observation and developed a more complete concept of the dura. Imbalances in the stride effect the attachments of the dura and can cause problems throughout the body. The one significant finding is that if the patient has a problem, and it is related to gait, you can place them into a gait position, one leg in front of another, and the pain disappears. At times, the gait position will allow hidden muscle weaknesses to be found.

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Cranial Dural Torque Frymann states that "Motion of the skull bones has been objectively measured". Research from Fryman, Michael and Retzlaff has consistently shown that the skull is moving at between 10 and 14 cycles per minute. This is unrelated to the heart rate or to respiration. The cranial dura consists of two layers. The cranial section of the dura is divided into the falx cerebri, the tentorium cerebelli and the falx cerebelli and finally the diaphragm sella. These structures firmly attach inside the cranial bowl. When chronic stress has been applied to the dura from either cranial/dental stress or due to chronic spinal imbalances, these attachments become tender on their external surface. An example of this problem is the person with a headache who feel relief by pressing in against the skull. This dural pressure follows a distinct pattern and requires a specific treatment pro-

tocol to correct it. TMJ Imbalances Goodheart first learned of the works of Willie May, a dentist in 1975. From this work, the initial treatments for TMJ balancing using muscle concepts were developed. These concepts were developed and expanded upon in the early 80’s in a chapter written by Goodheart in a text by Harold Gelb a dental expert in TMJ function. From this work, applied kinesiology has expanded in the dental profession, especially in Europe, and in schools like Tuft’s College of Dentistry.

In a book titled Acupuncture, A Comprehensive Text, by John O'Connor and Dan Benske, a discussion of the distribution and pathology of twelve muscle meridians can be found. These meridians follow the basic course of the normal meridians and interconnect with each other. Goodheart has found that imbalances in these meridians can be found if the examination is done in a gait position. He also found that palpation of these meridians will reveal an area that is extremely painful and feels like it is swollen.

Neurological Tooth There is a dental ligament surrounding each tooth. Currently, there are at least four different reflex related areas that imbalances in tooth occlusion can precipitate. The organ tooth - muscle - organ relationships were published by Goodheart in 1976. Since then, further advances in these conditions have been researched and documented especially by the dentists using applied kinesiology in Germany, Austria and Italy.

Meridian Related Therapies Then and Now According to the Chinese, the acupuncture energy flows through a 24 hour cycle in the body. It changes meridians every two hours, and follows a superficial flow of energy.

Beginning and End Technique This refers to a procedure developed by Goodheart in which the first and last points of meridians, which either start or end on the skull, are used for treatment. Goodheart found that treatment of these points changed many measurable parameters in the body. These included skin temperature, pH, vision, speech patterns, vitamin C absorption times, pituitary-hypothalamic function, etc.. This procedure is possibly indicated anytime there is an imbalance in a meridian that either starts or ends on the skull.

Visceral Related Therapies Visceral Manipulation

Diagnosis of problems occurring at specific times of the day can be enhanced by checking Portelli, following concepts first developed by the patient at that time. However, this may osteopaths and DeJarnette, has described that prove to be impractical. viscera can be challenged for their position. He wrote that if an organ is out of position and you Goodheart discovered a simple procedure using further displace the organ, the muscle related the alarm points and therapy localization to to the organ will test weak. determine what is imbalanced in the patient. The related weakness only occurs in the muscle Muscle Meridians that has been classically related with the or117

gan. There is not a general weakening of the muscles of the body. This is again evidence that the organ-muscle relationship does exist. The treatment consists of repositioning the organ and then testing for the proper muscle support for the organ.

awake - small intestine asleep". In addition to this concept in treating intestinal problems, it has been applied to other body funcitons like the immune system. Respiratory Procedures

For a complete discussion of the topic, read Specific techniques designed to increase resVisceral Manipulations by Barral and Mercier, piration have been developed over the years. an Eastland Press publication, P. O. Box 12689, From concepts and observations from Israel Seattle WA.. to Switzerland on the ionizing function of the turbinates in the nose, to methods to help reset the carbon dioxide metering system in the brain Ileocecal Valve Disorders to specific protocols to increase vital capacity. Goodheart and others in ICAK have developed The treatment of ileocecal valve problems was effective treatment regimes to improve the the first use of visceral manipulation in applied breathing capacity of the patient. kinesiology. Goodheart found that the valve could either be in an open or closed state. These Lymphatic Disorders imbalances had specific symptom patterns and nutritional as well as structural corrections. Beginning with the lymphatic reflexes of Over the years, other organs have been treated Chapman, Goodheart found methods to anausing the same basic concepts. Find the involved lyze whether they were indicated as part of a organ, test of the proper nerve control, test for treatment protocol or not. Other advances in related reflex corrections, test for meridian the treatment of lymphatic imbalnces are cenrelated problems and finally apply specific tered around restrictions in the right and left nutritional protocols to aid in the normaliza- lymphatic ducts and their clinical importance. tion of function. Additionally, Goodheart wrote about a nutritional imbalance that would lead to lymphatic Malabsorption fluid leaking from the lymph vessels. In the mid eighties, Goodheart became aware of some of the research that had been done by Candice Pert. At the same time, he was concerned with apparent malabsorption syndromes that he was finding in his patients. There appears to be an neuroendocrine axis that regulates the absorption of nutrients from the intestinal tract. This system works all day long, but is suppressed during stress times of the day.

In each of these cases, specific diagnostic signs and tests are used to make sure that the treatment is appropriate for the patient in question. Robert Fulford Concepts Fulford was an osteopath who developed specific ideas and treatments based on normalization of fascia and as he termed them “diaphragms”. These “diaphragms “ started with the feet and are found in the pelvis and solar plexus to name two others.

The other interesting observation was that the weakness pattern could only be produced by closing the eyes. Man is one of the only creatures that close their eyes when they are He also developed a concept of birth trauma asleep. Consequently, Goodheart at times would and the negative effects that this has on our say that this condition represented "patient health later in life. 118

Goodheart was able to organize these concepts and bring diagnostic criteria to them. The effects of these procedures help to normalize ROM, respiration and other visceral and structural problems found especially in the chronic patient. Anatomy Trains Thomas Myers, an anatomist, dissected fascial connections that he termed “anatomy trains”. These tend to follow from the feet ascending to the skull in specific patterns based on normal muscle function. Again, Myers developed a concept of these trains of fascial stress. Goodheart developed a method of diagnosis that the problem existed and then found a simple system for their correction. Leaf has shown that these patterns of aberrant muscle and fascial stress are usually related to foot subluxation patterns or to TMJ problems, depending on whether the problem is an ascending or descending muscle stress pattern.

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Appendix B Applied Kinesiology Status Statement cles. He observed that tender nodules were frequently palpable within the origin and/or insertion of the tested muscle. Digital manipulation of these areas of apparent muscle dysfunction improved both postural balance and the outcome of manual muscle tests. Goodheart and others have since observed that many conservative treatment methods improve neuromuscular function as perceived by manual muscle testing. These treatment A.K. is an interdisciplinary approach to methods have become the fundamental aphealth care which draws together the core ele- plied kinesiology approach to therapy. Includments of the complementary therapies, creat- ed in the AK approach are specific joint maing a more unified approach to the diagnosis nipulation or mobilization, various myofascial and treatment of functional illness. A.K. uses therapies, cranial techniques, meridian therfunctional assessment measures such as pos- apy, clinical nutrition, dietary management, ture and gait analysis, manual muscle testing and various reflex procedures. as functional neurologic evaluation, range of motion, static palpation, and motion analysis. With expanding investigation there has been These assessments are used in conjunction continued amplification and modification of with standard methods of diagnosis, such as the treatment procedures. Although many clinical history, physical examination find- treatment techniques incorporated into apings, laboratory tests, and instrumentation plied kinesiology were pre-existing, many to develop a clinical impression of the unique new methods have been developed within the physiologic condition of each patient, includ- discipline itself. ing an impression of the patient’s functional physiologic status. When appropriate, this Often the indication of dysfunction is the failclinical impression is used as a guide to the ure of a muscle to perform properly during the application of conservative physiologic thera- manual muscle test. This may be due to improper facilitation or neuromuscular inhibipeutics. tion. In theory some of the proposed etiologies The practice of applied kinesiology requires for the muscle dysfunction are as follows: 1 Myofascial dysfunction that it be used in conjunction with other (micro avulsion and proprioceptive standard diagnostic methods by profession- dysfunction) als trained in clinical diagnosis. As such, the 2 Peripheral nerve entrapment use of applied kinesiology or its component 3 Spinal segmental facilitation and assessment procedures is appropriate only to deafferentation individuals licensed to perform those proce- 4 Neurologic disorganization dures. 5 Viscerosomatic relationships (aberrant autonomic reflexes) The origin of contemporary applied kinesiology 6 Nutritional inadequacy is traced to 1964 when George J. Goodheart, 7 Toxic chemical influences Jr., D.C., first observed that in the absence 8 Dysfunction in the production and of congenital or pathologic anomaly, postural circulation of cerebrospinal fluid distortion is often associated with muscles 9 Adverse mechanical tension in the that fail to meet the demands of muscle tests meningeal membranes designed to maximally isolate specific musThe International College of Applied Kinesiology–U.S.A. provides a clinical and academic arena for investigating, substantiating, and propagating A.K. findings and concepts pertinent to the relationships between structural, chemical, and mental factors in health and disease and the relationship between structural faults and the disruption of homeostasis exhibited in functional illness.

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10 Meridian system imbalance 11 Lymphatic and vascular impairment



extremities. 2 Stretching muscle, joint, ligament, and tendon 3 The patient’s digital contact over the skin of a suspect area of dysfunction termed therapy localization 4 Repetitive contraction of muscle or motion of a joint 5 Stimulation of the olfactory receptors by fumes of a chemical substance 6 Gustatory stimulation, usually by nutritional material 7 A phase of diaphragmatic respiration 8 The patient’s mental visualization of an emotional, motor, or sensory stressor activity 9 Response to other sensory stimuli such as touch, nociceptor, hot, cold, visual, auditory, and vestibular afferentation

On the basis of response to therapy, it appears that in some of these conditions the primary neuromuscular dysfunction is due to deafferentation, the loss of normal sensory stimulation of neurons due to functional interruption of afferent receptors. It may occur under many circumstances, but is best understood by the concept that with abnormal joint function (subluxation or fixation) the aberrant movement causes improper stimulation of the local joint and muscle receptors. This changes the transmission from these receptors through the peripheral nerves to the spinal cord, brainstem, cerebellum, cortex, and then to the effectors from their normally-expected stimulation. Symptoms of deafferentation arise from numerous levels such as motor, sensory, autonomic, and consciousness, or from anywhere throughout the neuroaxis. Manual muscle tests evaluate the ability of Applied kinesiology interactive assessment the nervous system to adapt the muscle to procedures represent a form of functional meet the changing pressure of the examinbiomechanical and functional neurologic eval- er’s test. This requires that the examiner be uation. The term “functional biomechanics” trained in the anatomy, physiology, and neurefers to the clinical assessment of posture, rology of muscle function. The action of the organized motion such as in gait, and ranges muscle being tested, as well as the role of synof motion. Muscle testing readily enters into ergistic muscles, must be understood. Manual the assessment of postural distortion, gait im- muscle testing is both a science and an art. To pairment, and altered range of motion. Dur- achieve accurate results, muscle tests must ing a functional neurologic evaluation, mus- be performed according to a precise testing cle tests are used to monitor the physiologic protocol. response to a physical, chemical, or mental stimulus. The observed response is correlated The following factors must be carefully conwith clinical history and physical exam find- sidered when testing muscles in clinical and ings and, as indicated, with laboratory tests research settings and any other appropriate standard diagnos- 1 Proper positioning so the test muscle tic methods. Applied kinesiology procedures is the prime mover are not intended to be used as a single method 2 Adequate stabilization of regional of diagnosis. Applied kinesiology examination anatomy should enhance standard diagnosis, not re- 3 Observation of the manner in which place it. the patient or subject assumes and maintains the test position In clinical practice the following stimuli are 4 Observation of the manner in which among those which have been observed to al- the patient or subject performs the ter the outcome of a manual muscle test: test 1 Transient directional force applied to 5 Consistent timing, pressure, and the spine, pelvis, cranium, and position 122



6 Avoidance of pre-conceived impressions regarding the test outcome 7 Non-painful contacts -- non-painful execution of the test 8 Contraindications due to age, debilitative disease, acute pain, and local pathology or inflammation

tion and therapeutic goals: 1 Provide an interactive assessment of the functional health status of an individual which is not equipment intensive but does emphasize the importance of correlating findings with standard diagnostic procedures 2 Restore postural balance, correct gait impairment, improve range In applied kinesiology a close clinical associa- of motion tion has been observed between specific mus- 3 Restore normal afferentation to cle dysfunction and related organ or gland achieve proper neurologic control dysfunction. This viscerosomatic relation- and/or organization of body function ship is but one of the many sources of muscle 4 Achieve homeostasis of endocrine, weakness. Placed into perspective and prop- immune, digestive, and other erly correlated with other diagnostic input, visceral function it gives the physician an indication of the or- 5 Intervene earlier in degenerative gans or glands to consider as possible sources processes to prevent or delay the of health problems. In standard diagnosis, onset of frank pathologic processes body language such as paleness, fatigue, and lack of color in the capillaries and arterioles of When properly performed, applied kinesiology the internal surface of the lower eyelid gives can provide valuable insights into physithe physician an indication that anemia can ologic dysfunctions; however, many individube present. A diagnosis of anemia is only jus- als have developed methods that use muscle tified by laboratory analysis of the patient’s testing (and related procedures) in a manner blood. In a similar manner, the muscle-organ/ inconsistent with the approach advocated by gland association and other considerations in the International College of Applied Kinesiolapplied kinesiology give indication for further ogy–U.S.A. Clearly the utilization of muscle examination to confirm or rule out an associa- testing and other AK procedures does not nection in the particular case being studied. It is essarily equate with the practice of applied the physician’s total diagnostic work-up that kinesiology as defined by the ICAK–U.S.A. determines the final diagnosis. There are both lay persons and professionals An applied kinesiology-based examination who use a form of manual muscle testing withand therapy are of great value in the manage- out the necessary expertise to perform specific ment of common functional health problems and accurate tests. Some fail to coordinate the when used in conjunction with information muscle testing findings with other standard obtained from a functional interpretation of diagnostic procedures. These may be sources the clinical history, physical and laboratory of error that could lead to misinterpretation examinations, and from instrumentation. Ap- of the condition present, and thus to improper plied kinesiology helps the physician under- treatment or failure to treat the appropriate stand functional symptomatic complexes. In condition. For these reasons the International assessing a patient’s status, it is important to College of Applied Kinesiology–U.S.A defines understand any pathologic states or processes the practice of applied kinesiology as limited that may be present prior to instituting a form to health care professionals licensed to diagof therapy for what appears to be a functional nose. health problem. Approved by the Executive Board of the International College of Applied KineApplied kinesiology-based procedures are ad- siology–U.S.A., June 16, 1992. Updated ministered to achieve the following examina- May, 2001. 123

Links to Applied Kinesiology’s Published Research Papers as of June, 2012 Applied Kinesiology: Distinctions in its Definition and Interpretation, 2012. http://www.bodyworkmovementtherapies.com/article/S1360-8592(12)00122-2/abstract. Conservative Chiropractic Management of Urinary Incontinence Using Applied Kinesiology: A Retrospective Case-Series Report, 2012. http://www.journalchiromed.com/article/S1556-3707(12)00002-8/abstract Physical causes of anxiety and sleep disorders: a case report, 2012. http://www.ncbi.nlm.nih.gov/pubmed/22314717 Association of manual muscle tests and mechanical neck pain: Results from a prospective pilot study, 2011. http://www.ncbi.nlm.nih.gov/pubmed/21419360. In the developing model of Evidence-Based Medicine, the clinical studies that should be considered as providing evidence for the efficacy of a therapeutic system are: Single Case Study Case-Control Study Case Referent Study Case-Comparison Study Case Series Case Series-Control Cohort-Control Cohort Inception Cohort Cohort Analytical Survey Cost Benefit Analysis Cost Effectiveness Analysis Crossover Trial Before-After Trial Nonrandomized Control Trial Randomized Control Trial Systematic Literature Reviews Meta-analyses Each of these forms of evidence have now been abundantly provided by 45 years of published, peerreviewed AK research

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Chiropractic management of a 30-year-old patient with Parsonage-Turner syndrome. http://www.journalchiromed.com/article/S1556-3707(11)00156-8/abstract Conservative management of post-surgical urinary incontinence in an adolescent: A case history, 2011. http://www.ncbi.nlm.nih.gov/pubmed/21649458. Inter-Examiner Reliability of Manual Muscle Testing of Lower Limb Muscles without the Ideomotor Effect. http://www.chiroindex.org/?search_page=articles&action=&articleId=21711 Applied kinesiology methods for sciatica and restless leg syndrome, 2010. Iowa Chiropractic Society Review Applied Kinesiology management of long-term head pain following automotive injuries: a case report, 2010. http://www.chiroindex.org/?search_page=articles&action=&articleId=21424. Applied Kinesiology methods for a child with headaches, neck pain, asthma, and reading disabilities: a case study, 2010. http://www.chiroindex.org/?search_page=articles&action=&articleId=21378. Intraexaminer comparison of applied kinesiology manual muscle testing of varying durations: a pilot study. 2010. http://www.journalchiromed.com/article/S1556-3707(10)00006-4/abstract. Effect of a single chiropractic adjustment on divergent thinking and creative output: A pilot study, Part 1, 2010. http://www.chiro.org/ChiroZine/ABSTRACTS/Divergent_Thinking_and_Creative_Output.shtml. Applied Kinesiology management of candidiasis and chronic ear infections: A case history, 2010. http://www.chiroindex.org/?search_page=articles&action=&articleId=21346. Muscle Imbalance: The Goodheart and Janda Models, 2010. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54578. What Are You Doing About Muscle Weakness? Pt. 4: The Extremities, 2009. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54288.

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Developmental delay syndromes: psychometric testing before and after chiropractic treatment of 157 children, 2009. http://www.jmptonline.org/article/S0161-4754(09)00198-5/abstract. What Are You Doing About Muscle Weakness? Pt. 3: Lumbar Spine, 2009. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54009. What Are You Doing About Muscle Weakness? Pt. 2: Cervical Spine, 2009. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53894. What Are You Doing About Muscle Weakness?, 2009. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53765. Developmental Delay Syndromes and Chiropractic: A Case Report, 2009. Available as a chapter in the book: http://chiropracticpediatricresearch.web.officelive.com/printeditions.aspx. Manual biofeedback: A novel approach to the assessment and treatment of neuromuscular dysfunction, 2009. http://philmaffetone.com/mmt.cfm. Evaluation of Applied Kinesiology meridian techniques by means of surface electromyography (sEMG): demonstration of the regulatory influence of antique acupuncture points, 2009. http://www.ncbi.nlm.nih.gov/pubmed/19480696. A pilot study to determine the effects of a supine sacroiliac orthopedic blocking procedure on cervical spine extensor isometric strength. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780950/ Common Errors and Clinical Guidelines for Manual Muscle Testing: “The Arm Test” and Other Inaccurate Procedures, 2008. http://chiromt.com/content/16/1/16.

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A Moment of Remembrance for Dr. David S. Walther, 2008. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53458. A review of the literature in applied and specialised kinesiology, 2008. http://www.ncbi.nlm.nih.gov/pubmed/19156969. A Tribute to George J. Goodheart, Jr. D.C.: The Growth of the Chiropractic Research Culture, 2008. http://www.chiroeco.com/news/chiropractic-news.php?id=4200. A Multi-Modal Chiropractic Treatment Approach for Asthma: a 10-Patient Retrospective Case Series, 2008. http://www.chiropracticuniverse.com/Asthma-Research--Chiropractic-Treatment-128.html. Manual therapy in cervical dystonia: case report, 2008. http://www.springerlink.com/content/w5l067t242358716/. Developmental Delay Syndromes and Chiropractic: A Case Report, 2007. http://www.sorsi.com/developmental-delay-syndromes-and-chiropractic. Can ankle imbalance be a risk factor for tensor fascia lata muscle weakness?, 2008. http://www.ncbi.nlm.nih.gov/pubmed/18455436. Applied Kinesiology: An Effective Complementary Treatment for Children with Down Syndrome, 2007. http://www.townsendletter.com/July2007/kinesiology0707.htm. Foci and areas of disturbance in the trigeminal region. Implications for orthopedics, implantology, and Gnathology, 2007. http://www.springerlink.com/content/kp88t141m81vn634/. The Effects of Chiropractic Care on Individuals Suffering from Learning Disabilities and Dyslexia: A Review of the Literature, 2007. http://www.jvsr.com/abstracts/index.asp?id=280.

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A musculoskeletal model of low grade connective tissue inflammation in patients with thyroid associated ophthalmopathy (TAO): the WOMED concept of lateral tension and its general implications in disease, 2007. http://www.ncbi.nlm.nih.gov/pubmed/17319961. Neurological influences of the temporomandibular joint. http://www.bodyworkmovementtherapies.com/article/S1360-8592(06)00117-3/abstract On the reliability and validity of manual muscle testing: a literature review, 2007. http://chiromt.com/content/15/1/4. Cranial Therapeutic Care: Is There any Evidence?, 2006 http://chiromt.com/content/14/1/10/comments#237535 Proposed mechanisms and treatment strategies for motion sickness disorder: A case series. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647056/ The Ileocecal Valve Point and Muscle Testing: A Possible Mechanism of Action. http://minerva.mq.edu.au:8080/vital/access/manager/Repository/mq:1643 Can the Ileocecal Valve Point Predict Low Back Pain Using Manual Muscle Testing? http://minerva.mq.edu.au:8080/vital/access/manager/Repository/mq:1414 Applied Kinesiology in Chiropractic. http://www.chiroindex.org/?search_page=articles&action=&articleId=18790 Chiropractic Testing for Equilibrium and Balance Disorders. http://www.chiroindex.org/?search_page=articles&action=&articleId=19025 Symptomatic Arnold-Chiari malformation and cranial nerve dysfunction: a case study of applied kinesiology cranial evaluation and treatment http://www.ncbi.nlm.nih.gov/pubmed/15883570 Chiropractic care for a patient with spasmodic dysphonia associated with cervical spine trauma. http://www.ncbi.nlm.nih.gov/pubmed/19674642

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Evaluation of Chapman’s neurolymphatic reflexes via applied kinesiology: a case report of low back pain and congenital intestinal abnormality. http://www.ncbi.nlm.nih.gov/pubmed?term=Evaluation%20of%20Chapman%E2%80%99s%20neurolymphatic%20reflexes%20via%20applied%20kinesiology%3A%20a%20case%20report%20of%20 low%20back%20pain%20and%20congenital%20intestinal%20abnormality The importance of proprioceptive testing to chiropractic. http://www.chiroweb.com/mpacms/dc/article.php?id=46406

Dr. George J. Goodheart Founder of Applied Kinesiology Understanding how to unwind the complex web of chronic fatigue immune dysfunction syndrome. http://www.chiroindex.org/?search_page=articles&action=&articleId=18581 Applied Kinesiology and the Motor Neuron. http://www.chiroweb.com/mpacms/dc/article.php?id=9140 New diagnostic and therapeutic approach to thyroid-associated orbitopathy based on applied kinesiology and homeopathic therapy. http://www.ncbi.nlm.nih.gov/pubmed/15353020 Fix foot problems without orthotics. http://www.kinmed.com/ak18.html Applied Kinesiology: How To Add Cranial Therapy To Your Daily Practice. http://www.chiroweb.com/mpacms/dc/article.php?id=9200 AK Manual Muscle Testing: As Reliable As The Deep Tendon Reflex?, http://www.chiroweb.com/mpacms/dc/article.php?id=9243 Migraines – the Applied Kinesiology and Chiropractic perspective. http://www.sciencedirect.com/science/article/pii/S1360859202000657 AK classic case management: enuresis. http://www.kinmed.com/ak16.html. Applied Kinesiology and Down syndrome: a study of 15 cases. http://www.kinmed.com/ak16.html.

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Pediatric case history: cost effective treatment of block naso-lacrimal canal utilizing applied kinesiology tenets. http://www.kinmed.com/. A 39-year-old female cyclist suffering from total exhaustion caused by over-training and false nutrition. http://www.kinmed.com/. The piriformis muscle and the genitor-urinary system: The anatomy of the muscle-organgland correlation. http://www.kinmed.com/. Acupuncture in applied kinesiology: a review. http://www.kinmed.com/ak14.html. Applied Kinesiology and the Myofascia. http://www.kinmed.com/ak13.html. Applied kinesiology for treatment of women with mastalgia. http://www.ncbi.nlm.nih.gov/pubmed/14965552. Plantar fasciitis. http://www.sciencedirect.com/science/article/pii/S1360859200902031. A new breed of healers, Time Magazine Cover with George J. Goodheart, Jr. http://www.time.com/time/magazine/article/0,9171,999708,00.html

Applied Kinesiology’s Fundamentals The Clinical Utility of Force/Displacement Analysis of Muscle Testing in Applied Kinesiology. http://www.ncbi.nlm.nih.gov/pubmed/11264916. The role of the scalenus anticus muscle in dysinsulinism and chronic non-traumatic neck pain. http://www.kinmed.com/ak12.html. An applied kinesiology evaluation of facial neuralgia: a case history of Bell’s Palsy. http://www.kinmed.com/ak10.html.

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A Force/Displacement Analysis of Muscle Testing. http://www.ncbi.nlm.nih.gov/pubmed/11065332. Applied Kinesiology and the Immune System. http://www.kinmed.com/ak8.html. Manual Muscle Testing and Postural Imbalance. http://www.chiroweb.com/mpacms/dc/article.php?id=31991 Applied Kinesiology as Functional Neurology. http://www.manuellemedizin.org/. Expanding the neurological examination using functional neurologic assessment part I: methodological considerations. http://www.ncbi.nlm.nih.gov/pubmed/10681118. Expanding the Neurological Examination Using Functional Neurologic Assessment Part II: Neurologic Basis of Applied Kinesiology. http://www.ncbi.nlm.nih.gov/pubmed/10681119. Muscle Test Comparisons of Congruent and Incongruent Self-Referential Statements. http://www.ncbi.nlm.nih.gov/pubmed/10407911. Applied Kinesiology Helping Children with Learning Disabilities. http://www.kinmed.com/ak4.html. Applied Kinesiology and Homeopathy: A Muscle/Organ/Remedy Correlation. http://www.kinmed.com/ak4.html. Thoughts About Muscle Testing. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=44344 Evaluating and Treating Functional Hypothyroidism Utilizing Applied Kinesiology. http://www.kinmed.com/ak4.html. Point-Counterpoint: Is O-Ring testing a reliable method? http://www.ncbi.nlm.nih.gov/pubmed/10729974. The Systems, Holograms and Theory of Micro-Acupuncture. http://www.ncbi.nlm.nih.gov/pubmed/10729973.

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Interactions within the Triad of Health in AK Correlation of Applied Kinesiology Muscle Testing Findings with Serum Immunoglobulin Levels for Food Allergies. http://www.ncbi.nlm.nih.gov/pubmed/10069623. The effects of a pelvic blocking procedure upon muscle strength: a pilot study. http://www.sotousa.com/wp/?p=8195. Jugular Compression in the Diagnosis and Treatment of Cranio-sacral Lesions. http://www.kinmed.com/ak2.html. George Goodheart, Jr., D.C., and a history of applied kinesiology. http://www.ncbi.nlm.nih.gov/pubmed/9200049. Interexaminer Agreement for Applied Kinesiology Manual Muscle Testing. http://www.ncbi.nlm.nih.gov/pubmed/9106846. A preliminary inquiry into manual muscle testing response in phobic and control subjects exposed to threatening stimuli. http://www.ncbi.nlm.nih.gov/pubmed/8792320. Ear infection: a retrospective study examining improvement from chiropractic care and analyzing for influencing factors. http://www.ncbi.nlm.nih.gov/pubmed/8728460. Electromyographic Effects of Fatigue and Task Repetition on the Validity of Estimates of Strong and Weak Muscles in Applied Kinesiology Muscle Testing Procedures. http://www.ncbi.nlm.nih.gov/pubmed/7567418 The demystification of Chinese pulse diagnosis: An overview of the validations, holograms, and systematics for learning the principles and techniques. http://www.acupuncturejournal.com/TablesOfContents.shtml Educational Kinesiology with learning disabled children: an efficacy study. http://www.ncbi.nlm.nih.gov/pubmed/8177643 A pilot study on the value of applied kinesiology in helping children with learning difficulties. http://icpa4kids.org/Chiropractic-Research/a-pilot-study-of-applied-kinesiology-in-helping-childrenwith-learning-disabilities.html

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Somatic dyspnea and the orthopedics of respiration. http://www.chiroindex.org/?search_page=articles&action=&articleId=8334 Objective Measurement of Proprioceptive Technique Consequences on Muscular Maximal Voluntary Contraction During Manual Muscle Testing. http://www.ncbi.nlm.nih.gov/pubmed/1844106 Failure of the musculo-skeletal system may produce major weight shifts in forward and backward bending. Proc Inter Conf Spinal Manip. Washington, DC;May 1990:399-402. Reliability of Manual Muscle Testing with a Computerized Dynamometer. http://www.ncbi.nlm.nih.gov/pubmed/2407795 Somatosensory Evoked Potential Changes During Muscle Testing. http://www.ncbi.nlm.nih.gov/pubmed/2714940 Cybernetic Model of Psychophysiologic Pathways: II. Consciousness of Effort and Kinesthesia. http://www.ncbi.nlm.nih.gov/pubmed/2664061 Cybernetic Model of Psychophysiologic Pathways: III. Clinical impairment of Consciousness of Effort and Kinesthesia. http://www.ncbi.nlm.nih.gov/pubmed/2769091 Chiropractic Management of Chronic Obstructive Pulmonary Disease. http://www.ncbi.nlm.nih.gov/pubmed/3253396 Intrarater reliability of manual muscle testing and hand-held dynametric muscle testing. http://www.ncbi.nlm.nih.gov/pubmed/3628487 On the balancing of candida albicans and progenitor cryptocides: a triumph of the science of applied kinesiology. http://www.icakusa.com/wp-content/uploads/2011/08/AK-Research-Compendium-Dr-Scott-Cuthbert10-08-11-LATEST.pdf Physical balancing: Acupuncture and Applied Kinesiology. http://www.acupuncturejournal.com/TablesOfContents.shtml

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Diagnosis of thyroid dysfunction: applied kinesiology compared to clinical observations and laboratory tests. http://www.ncbi.nlm.nih.gov/pubmed/6747487 Effects of Manipulation on Gait Muscle Activity: Preliminary Electromyographic Research. ACA J Chiropr Oct 1983;17(10):49-52. New simple early diagnostic methods using Omura’s “Bi-Digital O-Ring Dysfunction Localization Method” and acupuncture organ representation points, and their applications to the “drug & food compatibility test” for individual organs and to auricular diagnosis of internal organs--part I. http://www.ncbi.nlm.nih.gov/pubmed/6124084 Neuromuscular relaxation and CCMDP. Rolfing and applied kinesiology. http://www.ncbi.nlm.nih.gov/pubmed/2701435 Applied kinesiology and dentistry. http://www.ncbi.nlm.nih.gov/pubmed/2957996 Applied Kinesiology: Muscle Response In Diagnosis, Therapy And Preventive Medicine. http://www.chiropractic-ecu.org/default.asp Quantification of the Inhibition of Muscular Strength Following the Application of a Chiropractic Maneuver. http://www.icakusa.com/wp-content/uploads/2011/08/Research-AK-Treatment-Effects.pdf Applied kinesiology and colon health. http://www.ncbi.nlm.nih.gov/pubmed/2994623 Uses of applied kinesiology for dentists. http://www.ncbi.nlm.nih.gov/pubmed/2931070 Applied dental kinesiology: temporomandibular joint dysfunction. http://www.ncbi.nlm.nih.gov/pubmed/6221716 Applied kinesiology--double-blind pilot study. http://www.ncbi.nlm.nih.gov/pubmed/6938675 An Experimental Evaluation of Kinesiology in Allergy and Deficiency Disease Diagnosis. http://orthomolecular.org/library/jom/1978/pdf/1978-v07n02-p137.pdf

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Evaluation of Muscle-Organ Association, Part I and II. http://www.icakusa.com/.../AK-Research-Compendium-Dr.-Scott-Cuthbert Applied Kinesiology: An opinion. http://www.drjohndiamond.com/index.php?option=com_content&view=article&id=136:applied-kinesiology-an-opinion&catid=45:main-kinesiology&Itemid=45 Applied kinesiology: its use in veterinary diagnosis. http://www.ncbi.nlm.nih.gov/pubmed/6916541 Kinesiology and Dentistry. http://www.chiroaccess.com/Articles/Technique-Summary-Applied-Kinesiology.aspx?id=0000144 Applied kinesiology – what does the term mean? (Letter to the Editor) J Am Dietetic Assoc, 89(4);Apr 1989:476. Combating a vitamin B deficiency Today’s Chiro, 17(2);Mar/Apr 1988: 19-22. Structural imbalance and nutritional absorption. Today’s Chiro, 16(1);Mar/Apr 1987:19-24. Managing lactic acid excess. Am Chiro, Sep 1989: 48-52. Structural imbalance and nutritional absorption. Am Chiro, Oct 1989:40-44. Celebrating Applied Kinesiology’s gold and silver. http://www.chiroeco.com/50/timeline/1980/ The Clorox Test: A Screening Test for Free Radical Pathology, Part I. http://www.chiroeco.com/50/timeline/1980/ Further Explanation of Surrogate Testing and Therapy Localization. http://www.chiroeco.com/50/timeline/1980/ Fundamentals of Essential Fatty Acid Metabolism, Parts I and II. http://www.chiroeco.com/50/timeline/1980/

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Kinesiology Korner: 21st Century Chiropractic. Am Chiro, Dec 1985:55. Applied Kinesiology celebrates 20th anniversary. http://www.chiroeco.com/50/timeline/1980/ A study of the results of Applied Kinesiology in a group of 123 Patients. http://www.icakusa.com/wp-content/uploads/2011/08/AK-Research-Compendium-Dr-Scott-Cuthbert10-08-11-LATEST.pdf Applied kinesiology: the advanced approach to athletic health care. Canadian Runner, May 1983:18-19. Dyslexia and learning disabilities cured. http://www.chiroeco.com/50/timeline/1980/ Applied kinesiology – the tangible measure of health imbalance and correction. Nature & Health, Winter 1982:79-81. Iron, Vitamin B-12, and Folic Acid: A Correlation of Laboratory Findings (Complete Blood Count with Differential) and AK Findings. http://www.chiroeco.com/50/timeline/1980/ German electro-acupuncture, Applied Kinesiology and gastric digestion. http://www.chiroeco.com/50/timeline/1980/ The education dimensions of Applied Kinesiology. http://www.chiroeco.com/50/timeline/1980/ A multi-disciplinary view of Herpes Simplex II. The Journal of Energy Medicine, 1980, 1:12. Applied kinesiology diagnosis and treatment of emotional stress overload. The Journal of Energy Medicine, 1980, 1:40-45. The good hands man. Sports Illustrated, 51(3);July 16 1979:34 Applied Kinesiology, related organs, meridians and ear-ricular therapy. Dig Chiro Econ, 1979;21(4):51-3.

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Vertebral fixations which mask other faults. Dig Chiro Econ, 1978;21(1):62-65. Applied Kinesiology used in detecting potentially harmful ingredients in nutritional supplements. Dig Chiro Econ, 1978;20(4):14-15. Kinesiological differentiation of low back syndrome including the pseudo disc and true disc and the ramrod spine. Dig Chiro Econ, 1978;20(4):60-65. Cranial Technique: A Clarification of Certain Principles. Dig Chiro Econ, Nov/Dec 1977;20(3):26-29,74. Correlative orthopedic kinesiology. Dig Chiro Econ,1977;20(1):32-4. One common cause of foot subluxations. Dig Chiro Econ, 1977;19(6):28. Experimental Characterization of The Reactive Muscle Phenomenon. Dig Chiro Econ, Sept/Oct 1976:44-50. Biofeedback and kinesiology. Journal of the American Society of Psychosomatic Disease. 1976; 6: 19-23. The vertebral challenge. Dig Chiro Econ, 1976;18(6):24-28. Applied Kinesiology and athletics. Dig Chiro Econ, 1976;19(2):30-32. Glaucoma and the kinesiological approach. Dig Chiro Econ, 1976;19(3):48-9.

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